A 26-year-old male presented to the outpatient department with complaints of painful decrease in vision in both the eyes for the past seven days. The decrease in vision was associated with photophobia and redness, more in left eye than right. There was no history of any trauma to any eye.On evaluation of his records, the patient was found to be a known case of severe dry eye, diagnosed two years earlier, for which he had taken treatment in the form of artificial tears and topical fluorometholone 0.1% occasionally for five to six months, but patient was off drugs for the past one and a half year.

Tolosa-Hunt syndrome (THS) is a rare clinical entity, characterized by sudden onset of painful ophthalmoplegia and prompt response to steroid therapy. Generally, it involves the third, fourth, and sixth cranial nerves due to presence of non-specific inflammation at the level of cavernous sinus or superior orbital fissure. In some cases, first or second division of trigeminal nerve may also be involved. Here we present a case report on THS, a rare cause of painful ophthalmoplegia. The patient presented with sudden onset, unilateral headache, drooping of left upper eyelid followed by diplopia. On examination, the patient had complete ophthalmoplegia, along with ophthalalmic division of trigeminal nerve was also involved. Magnetic resonance imaging (MRI) brain showed expansion of left cavernous sinus suggesting THS. Other differentials of THS were ruled out on the basis of careful history, examination, and investigations.

Introduction Nearly 6.8 million people in India have vision less than 6/60 in at least one eye due to corneal diseases; of these, about a million had bilateral involvement. Purpose To identify the challenges faced; the trends in collection, storage and utilisation of corneal tissues in an eye bank in north India. Materials and methods The past records of Eye Bank linked to a tertiary hospital in northern India were analysed from November’1999 to October’2015 with respect to number of eye donations per year, donor demographics and utilisation of corneal tissues. Results The number of donations during the first 6 years were 100, 279 in the next 5 years and 473 in the last 5 years. The mean donor age was 63.2 ± 19.5 years. The percentage of donors less than 30, 31–60 and more than 60 years was 10%, 28% and 62%. Forty-two percent donations were from the hospital. The average time between the death and enucleation was 4.74 ± 5.31 hours. The percentage of corneas used in the donor age groups less than 30, 31–60 and above 60 years was 61.9%, 61.6% and 53.8%, respectively. The usability rate of the corneas from home and hospital was 63.7% and 55.3%, respectively. Conclusions The eye bank had a lukewarm response in the beginning, but gained momentum with time. The myths and beliefs prevalent in our society deter people from donating eyes freely. Each eye bank needs to individualise its problems and find solutions for adequate procurement and utilisation of tissue.

Retrospective analysis of epidemiological and clinical characteristics of patients diagnosed with benign essential blepharospasm and hemifacial spasm who reported to the oculoplasty clinic of a tertiary eye care center in north India between January 2010 and April 2015 was carried out. Dry eye, as well as all the local factors that can cause blepharospasm or hemifacial spasm, was ruled out. Systemic evaluation was done to rule out any neurological disorder. A detailed history was taken to rule out any associated psychiatric disorders as well as use of any medication which could be responsible for dystonic movements. In every patient of hemifacial spasm, magnetic resonance imaging (MRI) of the brain was done for any facial nerve compression or tumor involving posterior fossa. Botulinum type A injections were given after assessing their requirements on the basis of guidelines given by Jankovic et al.

Purpose: To study the impact of diabetic retinopathy (DR) on the quality of life (QoL) of Indian patients with diabetes. Methods: This cross-sectional tertiary health care institution-based study involved 250 patients of DR. They were interviewed using four questionnaires, namely, the General Health Questionnaire (GHQ), Final Quality of Life Instrument for Indian Diabetic Patients (QoLID) questionnaire for diabetes and questionnaire modified for DR, retinopathy dependent quality of life (RetDQoL), and coping strategy checklist (CSCL). Results: The mean GHQ score was 1.12, indicating the absence of psychological morbidity. Mean QoLID score for financial worries and treatment satisfaction scores were 15 each for DR compared with 17 and 16, respectively, for diabetes mellitus (DM). The mean RetDQoL score was −27.94 (±2.14), showing the negative impact of DR on QoL. The mean CSCL score was 1.22 (±0.14), indicating infrequent use of coping strategies. Scores achieved by all four questionnaires correlated to each other. On subgroup analysis, proliferative DR (PDR) patients had a significantly higher GHQ score, lower treatment satisfaction, and more financial worries, with a poorer QoL than nonproliferative DR (NPDR). The severity of the disease had a negative impact on the QoL. The treatment satisfaction and psychological impact on the patients undergoing all types of eye treatments were comparable. Conclusion: DR has a significantly detrimental impact on the QoL, which increases with increasing severity of the disease.