Gonioscopy allows us to examine the angle of anterior chamber and forms part of complete ophthalmic examination and it is mandatory for the diagnosis and management of glaucoma. Gonioscopy permits the identification of eyes at risk for closure and detects angle abnormalities that could have diagnostic and therapeutic implications. Principle, types and techniques of gonioscopy, various types of gonioscopic lenses used, indications of performing gonioscopy, gonioscopic anatomy and grading are discussed in this article.

Xeroderma pigmentosum is a rare, autosomal recessive disease caused by a defect in DNA repair. Patients with xeroderma pigmentosum often have cutaneous and ocular sun sensitivity, freckle-like skin pigmentation, multiple skin and eye cancers, and, in some patients, progressive neurodegeneration. Xeroderma pigmentosum predominantly affects the ultraviolet (UV) exposed ocular surface, resulting in eyelid atrophy and cancers, corneal dryness, exposure keratopathy, and conjunctival tumors. General features included parental consanguinity (40%), familiarity (60%), onset of symptoms in the first 2 years (50%), malignant skin neoplasms (60%), and carcinoma of the tongue (20%). Among the ocular features, 50% of patients presented with photophobia. Lid freckles or atrophic skin lesions were seen in all patients. Lower lid tumours were seen in 30%, chronic conjunctival congestion in 40%, corneal opacification in 40%, squamous cell carcinoma of limbus in 20%, bilateral pterygium in 40%, and visual impairment in 50%. We report the clinical history and ocular pathology of a boy who is having xeroderma pigmentosum with ocular manifestations. The ophthalmic manifestations of xeroderma pigmentosum are discussed and reviewed with respect to this report and other cases in the literature. These cases illustrate the role of DNA repair in protection of the eyes from UV damage and neuron degeneration of the retina.

To compare surgical techniques for pterygium using mitomycin-C/5-fluorouracil as adjunct to surgery. SETTINGS AND DESIGN: A randomized, interventional, prospective, comparative study was conducted in Department of Ophthalmology, S.N Medical College, Agra for 2 years. MATERIALS AND METHODS: Patients underwent complete preoperative evaluation (complete history and ophthalmological examination). Ninety-eight eyes of 98 selected cases were divided into eight groups depending upon treatment protocol: I-Mitomycin-C (0.02%) with bare sclera II-Mitomycin-C (0.04%) with bare sclera III-Mitomycin-C (0.02%) with conjunctival autograft IV-Mitomycin-C (0.04%) with conjunctival autograft V-5-fluorouracil (10mg/ml) with bare sclera VI-5-fluorouracil (20mg/ml) with bare sclera VII-5-fluorouracil (10mg/ml) with conjunctival autograft VIII-5-fluorouracil (20mg/ml) with conjunctival autograft STATISTICAL ANALYSIS: Chi-square test was used to compare the outcome. RESULTS: Of 98 cases, 61 (62.24%) were male, 37 (37.75%) were female. The age ranged 18-66 years, with mean age of 44.6 years. Maximum cases were in age group 41-50 (48.98%). Seventy-nine (80.61%) had primary pterygium while 19 (19.39%) cases had recurrence. 74.49% were from rural area and 25.51% from urban background. 75.51% were outdoor workers while 24.49% were indoor workers. Involvement was bilateral in 71 (72.45%) cases. Ninety-five (96.94%) cases had nasal pterygium and 3 (3.06%) had both nasal and temporal. Most patients (73.47%) presented with complaint of ʿ growth in eyeʿ , followed by redness/congestion (16.33%). At reporting, corneal involvement in majority (64.28%) was 1-3 mm, and most patients (53.06%) consulted between 6-12 months of onset. The success rates, recurrence rates and ocular complications varied in various groups. The success rate was maximum (100%) in group-IV and minimum (72.73%) in group-V. Within mitomycin-C groups, conjunctival autograft revealed better results against bare sclera technique. No significant difference existed between low and high concentration groups with mitomycin-C or 5-fluorouracil, and even the mitomycin-C versus 5-fluorouracil groups. Groups IV and VIII revealed higher rate of complications including graft-injection and retraction (46.15% and 23.07% in Group-IV, and 61.54% and 23.07% in group-VIII), hematoma (23.07% and 30.77% in group-IV and VIII respectively), dryeye (15.38% and 7.69% in group-IV and VIII), granulation-tissue formation (7.69% in both), and scleral-thinning (7.69% in group-IV).

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Several types of childhood glaucoma exist, and the terminology is based on the time of onset of disease and its potential cause. Though childhood glaucoma occurs less commonly than adults but can lead to permanent visual damage due to amblyopia, optic neuropathy or refractive error. A detailed evaluation should be done to establish diagnosis. Medical therapy has a limited role and surgery remains main modality for treatment. Childhood glaucoma is a treatable disease, if early diagnosis is established and therapeutic intervention done in time. In children with low vision efforts should be there to maintain residual vision and visual rehabilitation with low vision aids should be done.