Background: Radiotherapy plays a critical role in the management of many patients with head-and-neck (H&N) cancer. To study the incidence of dry eye associated with radiotherapy and correlate them with dose of radiation.Methods: This Hospital based prospective study comprises of 100 patients of head and neck tumors who received radiotherapy by linear accelerator from 2015 to 2017. Ocular examination was done prior to the start of therapy, 1st follow up at 15th day of therapy, 2nd at last day of therapy (23-35 fraction), 3rd at 3 months after completion of therapy for side effects, 4th at 6 months, 5th at 12 month and 6th at 18 months after completion of therapy for assessing dry eye.Results: 59% patients developed dry eye. 44 patients received dose 45-55 Gy and out from these 13 (29.50%) patients developed dry eye, 40 patients received dose 56-65 Gy and out from these 33 (78.00%) patients developed dry eye and 16 patients received dose 66-70 Gy and out from these 13 (95.00%) patients developed dry eye.Conclusions: We concluded that the incidence of dry eye increased with increased total radiation dose. The current study suggests the importance of total dose as well as dose per fraction despite advancement of radiotherapy techniques and using protective mechanisms for eye complications developed.

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Purpose: Chronic kidney disease (CKD) is an emerging health problem worldwide. In CKD corneal endothelial changes also occur probably due to accumulation of inflammatory cytokines and increased multiple toxic products. The aim of this study was to analyze the effect of CKD on corneal endothelium and correlate the findings with severity of disease with help of noninvasive technique. Methods: The study comprised 75 eyes of 75 cases divided into three groups with group A comprising of CKD cases on dialysis, group B of nondialysis CKD cases, and group C of controls. Each group had 25 cases each of either sex and between 15–80 age groups. All patients were investigated for blood urea, serum creatinine, and blood sugar and underwent complete ophthalmic examination of both eyes along with wide-field specular microscopy examination. Results: The majority of patients (33.3%) belonged to age range of 61–70 years with male predominance and the most common cause of CKD was found to be diabetes with 17 (34%) cases. We found normal corneal endothelial cell density (ECD) with the mean ECD of 2364.52 ± 397.72 mm 2 in the dialysis group, 2467.8 ± 352.88 mm 2 in nondialysis group, and 2521.68 ± 250.26 mm 2 in the control group of patients. However, we found significant increase in coefficient of variation (CV) with 36 ± 5.8% in dialysis group, 37 ± 4.5% in nondialysis group and 32 ± 0.8% in controls ( P = 0.001) and decreased hexagonality (Hx) with 47 ± 7.3% in dialysis group, 46 ± 4.7% in nondialysis group and 51 ± 6.7% in the controls ( P = 0.031). This showed increased tendency of pleomorphism and polymegathism in corneal endothelial cells in CKD cases. No correlation was found between blood urea or serum creatinine levels with endothelial parameters in any group. Conclusion: CKD causes morphological changes like polymegathism and pleomorphism in corneal endothelium and hence these cases are more vulnerable and special care should be taken before any intraocular surgical procedure.

Background: Conjunctival autografting after Pterygium excision can be done by fibrin glue or sutures but use of foreign material can cause discomfort and infection. Fibrin glue may cause hypersensitivity reaction and also have risk of viral transmission. To avoid these conjuctival autograft can be applied without suture or glue. Patient’s own blood act as a bioadhesive.Methods: We done a prospective randomized control study of 70 patients, 35 patients allocated in each group. Group A had conjunctival autograft with fibrin glue while group B had conjunctival autografting without glue or sutures.Results: In group A 31 and group B 26 patients had well placed conjunctival autograft while 4 in group A and 9 patients in group B had either displaced or dislodged graft. The results were statistically insignificant with P value of 0.219 and No complication was reported in any patient except recurrence. The 5 patients in group A and 6 in group B had recurrence which is not statistically significant.Conclusions: Graft stability is more with fibrin glue as compare to glueless and sutureless conjunctival autografting but using patients own blood as bioadhesive is safer and cost effective. The rate of recurrence is similar in both the groups.

Introduction: Milliary tuberculosis occurs due to haematogenous spread of infection. It is assumed that intraocular tuberculosis is spread hematogenously from primary infection to elsewhere. The choroidal tubercles may be one of the earliest signs of milliary disease and is probably the most common form of ocular tuberculosis.Methods: This is a retrospective observational single site study of 113 patients with milliary tuberculosis from 2001 to 2015. Fundus examination was done after full dilatation of the pupil with direct and indirect ophthalmoscope. The diagnosis of intraocular tuberculosis was presumed to be based on suggestive ocular lesion in context of evidence of systemic infection and response to antitubercular treatment.Results: There were 77 females (68%) and 36 (32%) males. The commonest age group was 21 to 40 years as 67 (59.3%) patients belonged to this productive age group. Eighty eight (77.9%) patients were from rural areas. Fundus changes were present in 14 patients (12.39%) and these were choroidal tubercles (8.8%), papillitis (4.4%), macular edema (0.9%) and vitritis (0.9%). Choroidal tubercles were present in 10 patients. Among these, two had associated papillitis and one also had vitritis. Three patients had only papillitis and in another one, only macular edema was present. Papillitis was present in five patients in our study. HIV did not increase the incidence of ocular lesions. Conclusion:The most common fundus changes were choroidal tubercles and optic neuropathy in our series. Early detection of these choroidal tubercles may be helpful in diagnosis as well as in treatment. The optic nerve may be involved not only by the toxic effect of anti-tubercular drug but also in the disease process itself.