AIMTo evaluate the clinical profile of patients with disc edema/papilloedema and its pattern in various patients. PURPOSETo evaluate causes of Disc edema/Papilloedema and associated clinical picture. DESIGNProspective Study. METHODThis study is a non-randomized prospective case series being conducted in the patients with disc edema attending OPD and referred from other departments to RIO, Gandhi Medical College and associated Hamidia Hospital, Bhopal from Jan 2013-Sept 2014. Detailed history was taken with special preference to diminution of vision, headache, nausea, vomiting, sensory motor deficits experienced by patient. Examination including visual acuity, pupillary reaction and ophthalmoscopy findings were noted. Findings of neuroimaging investigations as advised by medicine and surgery experts in cases suspected of raised intracranial tension were noted. RESULTSMost commonly affected age group was 11-20 years. Females: Males ratio were 4.1:3 with bilateral predominance. Intracranial Space Occupying Lesion (ICSOL) was most common cause of papilledema in bilateral (b/l) cases. Optic neuropathy was most common local cause of unilateral disc edema. Headache was the most common presenting complaint. On radiological investigations, most common finding was ICSOL followed by sinusitis followed by venous thrombosis, demyelination and infarction, Lateral Rectus (LR) palsy and diplopia each were found to be present in 4% cases of disc edema. CONCLUSIONIntracranial space occupying lesions as suggested by neuroimaging were the most common cause of papilledema. Other associations included hypertension, meningitis, pseudotumor cerebri, anaemia.The study emphasizes ophthalmoscopy in the diagnosis of papilledema and its importance in intervention of neurosurgeon in saving life and sight of person.

PURPOSE:To compare the surgically induced astigmatism following straight, frown and modified chevron incisions in MSICS. METHOD: This is a Prospective interventional study conducted in RIO Bhopal during academic session of April 2009 to October 2010 in which 145 eyes of 137 patients were evaluated. Patients with relatively soft nuclei and healthy cornea, adequate anterior chamber and those who could be called up for regular follow up were chosen for the study. Preoperative keratometry was done to determine K-reading in both horizontal and vertical meridians. Astigmatism was graded and classified according to Holmström's gradation 1 37.9% cases were given straight incision, 18.6% cases were given Frown incision. While in the remaining 43.4% cases Modified chevron was made. In majority of cases 71%, 6.5 mm incision was made while larger incision 7mm and 7.5mm were made in 23.4% and 5.5% cases respectively. Post-operative keratometry readings were taken at first post-operative day and at the end of 6 th week following surgery and surgically induced astigmatism was calculated. RESULTS: Post operatively frown incision group's average SIA was 0.68 D. Modified chevron incision group had 1.02 D SIA, Straight incision group had the maximum SIA of 1.15D. However the mean surgically induced astigmatism in all incision types in our study was found to have SIA=1.01 D. CONCLUSION: In our study we observed that Frown incision was the best of all incision types with regards to SIA. KEYWORDS: SIA, Modified chevron incision, straight incision, frown incision. INTRODUCTION:In the developing countries where cost 1 is a major issue, MSICS was developed after the advent of phacoemulsification, and hence it is a relatively younger technique than the latter. Innumerable variations in methodologies of MSICS as well as the utility of MSICS in the day to day practice invoke a great deal of discussion and debate. In MSICS which is based on the concept of scleral tunnel, everything about the wound has to be carefully planned depending on the type of technique, hardness of the nucleus, amount of preoperative astigmatism. 2,3 It has been unequivocally demonstrated that smaller the incision, 4,5 lesser the number of sutures 6,7 and valvular construction of wound would induce minimal corneal curvature change that is astigmatism. The parameters 8 important for the structural integrity of the tunnel are- The self-sealing property of the tunnel.  The location of the wound on the sclera with respect to the limbus, 7,9 and  The shape of the incision. 7,10 Cataract surgery has gone beyond just being a means to get the lens out of the eye. Postoperative astigmatism plays an important role in evaluation of final outcome of surgery. Astigmatic consideration hence forms an integral part of incisional considerations prior to surgery.

PURPOSE:To compare RNFL thickness in patients with ocular hypertension with that of controls. AIM: To study the role of SD-OCT in ocular hypertension. METHODS: 25 eyes of 15 patients with ocular hypertension and 25 eyes of 15 normal subjects seen in Regional Institute of Ophthalmology, Gandhi Medical College Bhopal were included in this prospective study conducted in the academic session of the year 2012 to 2013. Informed consent was obtained from all patients and controls. Ocular hypertensive eyes were defined as an IOP reading greater than 21 mmHg on at least two separate occasions, normal optic disc, visual fields and normal open angles. The control was selected from general OPD and staff of RIO. Control subjects were included if they had an IOP measurements less than 21 mmHg on at least two separate occasions, absence of glaucomatous optic nerve head, normal visual fields and no family history of glaucoma or other risk factors. Age and sex matched controls were included in the study. CONCLUSION: OCT can be useful adjuvant in ocular hypertensive patients for measurement of structural loss which precedes functional loss alerting ophthalmologist to start early treatment especially in presence of risk factor and contributes to quality of life. SD-OCT could determine significant differences between ocular hypertensive patients and healthy subjects in RNFL thickness measurement.

AIM: Management of ptosis by frontalis sling procedure. PURPOSE: To study cosmetic and functional outcome by frontalis sling procedure. METHOD: This is a Retrospective interventional case series studied in RIO Bhopal during academic session of January 2012 to December 2013 in which 18 patients with severe Ptosis with poor levator function attending OPD were evaluated. All cases in our study were of congenital ptosis (100%) with poor levator function (<4mm). Amount of ptosis determined with Ptosis workup. Phenylephrine test was carried out in all patients to test the function of Muller muscles. Polypropylene suture and silicone rod were used in 50% cases each; similarly single triangle and pentagon technique done in 50% cases each. All surgeries were done with eyelid crease incision, Post-operative outcome assessed in terms of palpebral fissure height (PFH), marginal reflex distance (MRD), visual acuity and lid Margin contour. Follow up was done after one month and 3months of surgery. RESULT: Surgical outcome-88.89% cases improved up to expected correction; under correction in 11.11% cases. On 3 month follow up lagophthalmos seen in 22.22%cases, lid crease abnormality in 16.66%, and recurrence in 11.11% suture exposure in 5.55% cases. Cosmetic outcome-excellent cosmesis observed in 22.22% cases, followed by good cosmetic outcome in 66.67% cases with 11.11% cases with poor cosmetic outcome. Silicon rod and pentagon technique have better outcome. CONCLUSION: In our study we observed that silicon rod found to have better mean ptosis correction and low rate of complications than polypropylene suture. Pentagon technique has better functional and cosmetic outcome than single triangle. Most of the patients were satisfied with the functional and cosmetic result of the surgery.