Purpose: To analyze the visual outcome in patients with traumatic optic neuropathy (TON) with respect to different treatment modalities, to study the correlation of initial visual loss with the final visual outcome, and to find out the predictor of final visual outcome in patients with indirect TON. Methods: A retrospective analysis of 36 eyes with TON was done. Data on clinical profile, including demographics, mode of trauma, best corrected visual acuity (BCVA), pupillary reflex examination, and anterior and posterior segment examination, was collected. Presence and location of orbital and cranial fractures were identified from computed tomography scan. Visual outcomes following steroid therapy, optic nerve (ON) decompression, and in untreated patients were analyzed. Pre- and post-treatment BCVA were divided into three groups based on logarithm of the minimum angle of resolution (logMAR) as follows: group A: 3, group B: 2.9–1.3, and group C<1.3. BCVA values at follow-up visits were taken as the primary outcome measure. Association between various risk factors and final visual outcome in patients with indirect TON was also analyzed. Results: Out of 34 patients whose 36 eyes were studied, three (8.8%) patients were females and 31 (91.2%) patients were males. Most common mode of trauma was road traffic accident (RTA; 91.2%), which was followed by fall (8.8%) and assault (2.9%). Pre- and post-treatment BCVA values of 36 eyes were compared, and improvement in BCVA after treatment was found to be statistically significant. Also, 28.6% of patients with presenting BCVA of no light perception showed improvement compared to 94.1% and 100% in groups B and C, respectively. Orbital wall fractures were seen in 80.5% (n = 29) of the patients, with lateral wall fracture being the most common (58.3%) followed by medial wall (33.3%), roof (27.7%), floor (27.7%), and optic strut (5%). Conclusion: Baseline BCVA had significant association with final vision improvement. Lateral wall fracture was the most common fracture associated with indirect TON. Patients treated with high-dose corticosteroids, irrespective of the time of presentation, had a better visual outcome.

: Aim of this article was to study the role of demographics in the incidence of pterygium and its surgical outcome and also to study the change in astigmatism in patients undergoing pterygium excision with conjunctival auto graft in the southern Indian state of Kerala.: 46 eyes of 43 patients with pterygium were studied over a period of 2 years. A complete ophthalmological examination was done. Patient data like age, sex, residing area and occupation were collected. All the patients underwent pterygium excision with auto conjunctival graft under local anaesthesia. Outcome variables like best corrected visual acuity (BCVA), keratometry, subjective refraction and extent of pterygium were recorded preoperatively as well as postoperatively at 1 month and analysed for the change in astigmatism.: Incidence of pterygium was more among patients of the age group 50-70 years, fishermen (28.3%), housewives (21.7%) and among residents of coastal area (71.7%). There was no significant difference between male and female. Majority of the patients were found to have with the rule astigmatism (56%) preoperatively with a mean of 0.88. There was a significant reduction in astigmatism postoperatively in 39 eyes with only 15.4% having clinically significant astigmatism.: There is a significant role for patient demographics in the incidence of astigmatism along the coastal areas with fishing being the most common occupation. Pterygium excision with auto conjunctival graft results in significant reduction in astigmatism which leads to improvement in visual acuity.

PURPOSE: The purpose of this study was to identify the incidence of dysphotopsia and other associated complications after inferotemporal laser peripheral iridotomy (IT-LPI). METHODS: This is a cross-sectional study on patients who underwent IT-LPI with neodymium: yttrium–aluminum–garnet laser who were followed up for a minimum of 3 months. RESULTS: In our study, out of a total of 116 patients, new-onset dysphotopsia was reported in 6.03% and significant pain during the procedure in 12.93% of patients. Other complications noticed were photophobia in 29.31% (34/116), rise in intraocular pressure at the end of 3 months in 1.72%, pigment dispersion in 0.86%, epiretinal membrane formation in 04.31%, and cystoid macular edema in 1.72%. No patients had hyphema or diplopia. CONCLUSIONS: The incidence of dysphotopsia following IT-LPI was relatively low in our study and was comparable to the superior PI under full lid cover from the literature. Although dysphotopsia rates were not superior, no patient developed hyphema, which could be due to the remoteness of the laser spot to the larger blood vessels located at 3 and 9 o'clock positions. Furthermore, the procedure was well tolerated as significant pain was reported by only less than a quarter of the patients. Hence, IT-LPI can be considered an easy to perform, safe, and comfortable procedure for the patient.

Dry eye can initially cause mild symptoms of irritation and may rapidly progress to corneal scarring and blindness. Tear substitutes can only help for mild cases. With the advancement in microsurgical techniques, an option of transferring vascularized salivary glands has shown positive results. We present a case of a 5-year-old boy with congenital alacrimia with ocular surface damage. Vascularized autologous submandibular gland transfer was considered as a viable option for this patient. We performed the gland transfer in two separate stages for the two eyes (1 year 5 months apart). The patient was evaluated for up to 2 years for the right eye and for 7 months for the left eye. Dry eye workup showed drastic improvement (right > left). Biochemical analysis showed gradual transition to resemble that of natural tears. This procedure can result in significant symptomatic improvement and can be a promising treatment option for cases of severe dry eye.