Purpose: The aim of this study is to describe the complications and outcome of sutureless scleral fixated intraocular lens (SFIOL) implantation in traumatic aphakia. Setting: The study was conducted in a tertiary eye care centre in South India. Design: The study involved a retrospective data analysis. Methods: Medical records of cases with traumatic aphakia who had undergone sutureless SFIOL implantation in the last 2 years were included in the study. Data on intraoperative and postoperative complications and visual outcome were collected and analysed. Results: In total, 45 cases were recruited. Mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) improved from preoperative 1.64 ± 0.45 to 0.63 ± 0.36 at last follow-up visit, and the difference was statistically significant ( p < 0.0001). Final logMAR BCVA was worse than one in three patients who had associated posterior segment pathology. There was no incidence of intraoperative haptic rebound into the vitreous cavity or intraocular lens (IOL) drop. Four cases had hypotony, two cases had choroidal detachment, four cases had raised intraocular pressure (IOP), eight cases had transient corneal oedema and six patients had mild dispersed vitreous haemorrhage during immediate postoperative period. Six patients had postoperative cystoid macular oedema (CME). Two cases developed glaucoma. None of the patients had postoperative haptic exposure, retinal detachment (RD), iris capture of IOL or SFIOL dislocation till the last follow-up. Conclusion: Final visual outcome of sutureless SFIOL implantation in traumatic aphakia may be affected by concomitant posterior segment pathology. The immediate and late postoperative complications noted in our study were comparable with other similar studies. However, longer follow-up is needed to detect RD and angle recession glaucoma at the earliest and initiate therapy.

Purpose: To assess the perinatal risk factors, clinical characteristics, and microbial profile in congenital nasolacrimal duct obstruction (CNLDO).Methods: A prospective observational study was conducted in pediatric patients of age <5 years. After a thorough clinical evaluation, the diagnosis of the CNLDO was confirmed by a Jones dye test or fluorescein dye disappearance test. A microbiological culture of lacrimal sac resurge was done with a sterile swab stick without touching the lid margins. Antibiotic susceptibility was then performed for the standard antibiotics.Results: Seventy-one eyes of 52 children were included in the study. The mean age was 3.4 months. Our research found an equal number of cases born via spontaneous vaginal delivery and Caesarean section. Nine children (17.3%) had associated systemic and ocular anomalies. The number of cultures that were positive for any growth was 19 (27%). The most common isolate was Streptococcus pneumoniae which constituted eight cases (42%), followed by Pseudomonas aeruginosa (15.8%), and Escherichia coli (10.5%). Other organisms that grew were Klebsiella pneumoniae, Staphylococcus aureus, Staphylococcus epidermidis and nonfermenting gram-negative bacilli. Gram-positive organisms were susceptible to ciprofloxacin, amoxiclav, and oxacillin, and most of them were resistant to erythromycin. In comparison, gram-negative organisms showed 62.5% resistance and 37.5% susceptibility to ciprofloxacin.Conclusions: CNLDO was more commonly unilateral, in male, preterm, and normal birth weight infants. Bilateral CNLDO was more commonly associated with coexisting ocular or systemic anomalies. Prematurity, delivery by Caesarean section, and presence of congenital anomalies were associated with a prolonged course. S. pneumoniae was the predominant isolate in our patient population.

A 5-year-old girl presented with penetrating ocular trauma associated with severe intraocular inflammation and hypotony persisting after globe repair. On re-exploration, intraocular eyelashes were found in the posterior chamber causing fibrosis and ciliary body traction. The child underwent membranectomy with anterior vitrectomy. Postoperatively, the inflammation subsided with steroids and cycloplegic therapy and vision improved to 6/24. This report describes a unique case of intraocular eyelashes that caused severe inflammation along with hypotony that were not found by routine slit-lamp examination but identified during membranectomy.

We report the rare case of timolol-induced sinus bradycardia in an otherwise healthy young individual following just 1 day use of timolol eye drops. A 35-year-old male presented with dispersed hyphema and raised intraocular pressure following blunt trauma in the left eye. He was prescribed timolol eye drops and topical steroids. He presented next day with giddiness, sweating, and heart rate (HR) of 30/min. Electrocardiogram confirmed sinus bradycardia injection atropine 0.5 mg intravenous was given. Timolol was substituted with brimonidine-brinzolamide drops. HR returned to normal of 72/min after 2 days of observation. Our case, therefore, represents an exaggerated response to topical timolol.

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