Background Rhino-orbital–cerebral mucor mycosis (ROCM) is a relatively rare opportunistic infection caused by the Mucorales species. While ROCM suggests involvement of the paranasal sinuses, orbit and brain ROM (rhino-orbital-Mucormycosis) stands for the fungal invasion in sinuses and orbit sans cerebral involvement. In India with the outbreak of the second COVID wave and the delta variant of the virus, there has been a steep increase in this opportunistic fulminant fungal infection, named COVID-associated Mucor mycosis (CAM). The most critical question in orbital management is when to go ahead with an exenteration. Our study aims to design a pertinent minimal invasive surgical protocol for surgeons to manage such cases based on our surgical experience and mitigate the need for exenteration and save the eyes wherever possible. Methods The study is a retrospective analysis of patients of ROM with and without brain involvement, who underwent minimal surgical management between March 2021 to March 2022 along with their follow-up. Results There were 184 eyes of 148 patients diagnosed with CAM. The mean age was 51.7 years with a male predominance of 103 (70%). All patients developed ROM following the COVID-19 infection and the duration between diagnosis of COVID-19 and ROM was 36 ± 23 days. 18 cases (12%) were bilateral. 76 eyes (41%) had no vision at the presentation. Imaging revealed paranasal sinus involvement (100%), orbital apex involvement (61%), cavernous sinus involvement (53%), and central nervous system (CNS) involvement (47%). All the patients (100%) were treated with systemic Liposomal amphotericin-B and sinus debridement. Endoscopic debridement of the orbital disease was performed in 45 (30.4%) cases, 15(8.1%) eyes underwent exenteration and were later rehabilitated with a customized ocular prosthesis, 103 (56%) eyes underwent transcutaneous retrobulbar amphotericin-B. At a mean follow-up of 13.1 months; the complete resolution was seen in 25 (17%) cases, the residual stable lesion was seen in 77(52%) of the cases and new lesions were developed in 13(9%) of the cases. Mortality was seen in 33 (22%) patients and all of them had CNS involvement. Conclusions Systemic and protocol-based management can save the life and salvage the eyes.

Objective To defi ne the role of canine fossa approach when standard endoscopic endonasal sinus surgery technique fails.Study design Retrospective review of all endoscopic sinus surgeries performed from 1992 to 2007.

Purpose: To study the hemodynamic parameters in ophthalmic artery (OA) using color Doppler imaging in subjects with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG) and age matched normals. Methods: Sixty-eight eyes of 68 subjects (41 males and 27 females) constituted material for this prospective observational study. They were divided into three groups; Group A had 24 patients with POAG, Group B had 18 patients with NTG and Group C had 26 normal subjects. They underwent CDI of OA. The outcome variables were peak systolic velocity (PSV), end diastolic velocity (EDV), resistivity index (RI) and pulsatility index (PI). Data were compiled and analyzed using one-way ANOVA analysis. Results: The mean ± SD age of POAG patients, NTG patient and normal subjects was 59.

Aim. To find out the influence of learning effect on various reliability parameters and global indices of standard automated perimetry in cases of primary open angle glaucoma.Method. Thirty eyes of 30 patients of Primary Open Angle Glaucoma constituted material for this prospective observational study. All the patients underwent standard automated perimetry three times on three different days within one week on G program of Octopus Visual Field Analyzer. The details of reliability indices, global indices, and test duration were compiled and analyzed.Result. A male preponderance was observed with a mean age of 53.43 years. The mean false positive was found to be 11.13, 6.07, and 2.40 on visit 1, visit 2, and visit 3, respectively. The mean false negative was found to be 13.73, 9.33, and 6.30 on visit 1, visit 2, and visit 3, respectively. The mean fixation loss was found to be 7.53, 3.83, and 1.60 on visit 1, visit 2, and visit 3, respectively. The mean deviation was found to be -10.14, -5.75, and -3.11 on visit 1, visit 2, and visit 3, respectively. The pattern standard deviation was found to be 5.58, 4.63, and 4.35 on visit 1, visit 2, and visit 3, respectively. The mean test duration was found to be 7.68, 6.21, & 5.51 minutes for visit 1, visit 2 and visit 3, respectively. All the values were statistically highly significant except for the pattern standard deviation. Conclusion. At least three standard automated perimetry tests should be performed for all glaucoma patients in order to obtain a base line perimetry chart.

Alport’s syndrome is an inherited disease characterized by hearing loss, progressive renal failure and ocular abnormalities like anterior lenticonus, corneal opacities, cataract, fleck retinopathies, and temporal retinal thinning. To have anterior and posterior lenticonus in the same eye in this syndrome is a rare finding and only a few such reports are available. Hereby, we report a case of a 22-year-old male with bilateral combined anterior and posterior lenticonus with sensorineural deafness and nephritis leading to the diagnosis of Alport’s syndrome.