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Purpose To report relationship of age group and axial length (AL) category to lens thickness values in eyes with a clear lens or different types of isolated cataract (nuclear, cortical, and posterior subcapsular (PSC)). Further, we evaluated lens thickness values on anterior chamber depth (ACD) in these eyes. Design Observational clinic-based study. Methods An observational study of 1442 eyes of 1442 individuals (816 eyes with isolated cataract and 626 eyes with clear lens) of those above 25 years of age was evaluated. AL and lens thickness were performed with an A-scan ultrasound after dilatation of the pupil, and manual optical pachymetry was used to measure ACD after dilatation of the pupil. Main outcome measures: Lens thickness. Results Multiple regression analysis revealed that with each decade of advancement in age, the lens thickness increased by 0.155 mm (Po0.001). The difference in lens thickness after adjusting for age group and AL category was less in cortical cataract by À0.25 mm (Po0.001) and PSC by À0.29 mm (Po0.001); With advancement in AL category, lens thickness decreased by 0.004 mm (Po0.001). After adjusting for all the parameters/variables, regression analysis revealed that as lens thickness increased, there was a significant decrease in ACD (mean À0.44 mm; Po0.001). Conclusions Lens thickness was significantly greater in clear lenses when compared with isolated cataractsFgreatest with nuclear cataract and least with PSC. Age group and AL category had a significant impact on the lens thickness of both cataract and clear lens. A significant decrease in ACD was found with the increase in lens thickness.

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Purpose:To know the pattern of presentations and management outcome of steroid induced glaucoma in vernal keratoconjunctivitis (VKC).Methods:Children of VKC using steroid with two of the following criteria were enrolled: Intraocular pressure (IOP) >21 mm Hg, glaucomatous optic disc and visual field defects. Misused topical steroids were classified in 4 groups; A- Highly potent drugs (dexamethasone, betamethasone), B- Moderate (prednisolone), C- Weak (loteprednol, fluorometholone), D- Unknown drugs. Active/conservative interventions were done to control IOP. Corrected distance visual acuity (CDVA), IOP, anterior segment and fundus examinations were noted. One-way ANOVA test and post hoc Tukey HSD test were used to compare the groups.Results:Out of 1423 VKC patients, 240 were using topical steroid without prescriptions. 92 eyes of 47 patients had steroid induced glaucoma. Hence prevalence of this complication was 3.30% in this study population. Mean age was 14.1 ± 3.8 years. Mean IOP was 38 ± 12 mm of Hg and mean vertical cup disc ratio was 0.67 ± 0.25. IOP was controlled by withdrawal of steroids (9 eyes), with antiglaucoma medications (27), trabeculectomy (57) and glaucoma drainage device (1). Mean CDVA at presentation was better in group C (0.23 log MAR). Mean IOP was highest in group A (43.1 mm Hg) followed by group D (40.5 mm Hg). At presentation 17 were blind (CDVA <3/60). Post treatment marginal improvement in CDVA was found (P = 0.46). However, statistically significantly improvement was noticed in IOP (P < 0.00001).Conclusion:Injudicious use of steroids leads to vision threatening complications like ocular hypertension and glaucoma in children of VKC. Weak steroids like loteprednol or fluorometholone should be used instead of higher potency drugs. Vision and IOP should be monitored fortnightly in children using topical steroids to detect steroid responders at the earliest.

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