Congenital teratoma is a rare cause of congenital proptosis. A full term three-day-old male child was presented with massive unilateral swelling in the left orbit, which was noted since birth. Diagnosis of orbital teratoma without intracranial extension was made based on clinical examination and imaging. Lid-sparing exenteration of the left orbit was done. Histopathological examination confirmed the diagnosis of cystic teratoma. Congenital orbital teratoma with a tooth and mature elements of all the three germ cell layers is reported due to its extreme rarity.

The objectives of the study were to identify the prevailing trend of specialty related career choices and major factors affecting it amongst the newly passed medical graduates of West Bengal, India. It was a questionnaire based cross sectional study. A total of 600 young doctors participated in the study; out of 600, 301 (50.16%) had opted for surgery and allied branches whereas 273 (45.50%) opted for medicine and allied branches. Only 26 (4.37%) had chosen pre and para clinical subjects as their desired area of specialization. According to their choice, their preferred disciplines were Radio diagnosis 106 (17.66%), Orthopedics 95 (15.83%) , Gynae and Obstetrics 88 (14.66%), Pediatrics 64 (10.66%), General Medicine 59 (9.83%), General Surgery 32 (05.33%) and Ophthalmology 39 (06.50%). Amongst the male candidates, subjects selected in order of preference were Orthopedics 95 (28.10%), Radio diagnosis 67 (19.82%), Pediatrics 35 (10.35%), General Medicine 30 (8.87%), General Surgery 23 (06.80%), and Ophthalmology 21 (06.21%). Male doctors had no inclination for pre and Para clinical subjects. Whereas female doctors opted for Gynae and Obstetrics 73 (27.86%), Radiology 39 (14.88%), Pediatrics 29 (11.06%), General Medicine 29 (11.06%) and Ophthalmology 18 (06.87%). Noteworthy 26 (9.92%) female candidates had shown interest for pre and Para clinical subjects. Among the reasons concerned behind these choices of specialty, major factors were anticipating high earnings 207 (34.58%), passion for the subject 175 (29.17%), better quality of life 125 (20.83%). The huge disparity between nation's needs and area of interest of the emerging medical graduates is taking the toll in the terms of wastage of human resources and government funds. Counselling programmes for career development is necessary to make each specialty equally lucrative and interesting to the candidates. Necessary changes and rectifications may be required. This should be supported by the necessary government initiative and changing social attitude.

PURPOSE: To evaluate the efficacy of paired intraoperative arcuate transverse keratotomy at a 7- mm- diameter zone along with a 3.5-mm clear corneal phaco tunnel in the steeper axis to correct pre-existing astigmatism. METHODS: A prospective randomized case-control study was conducted on 34 eyes of 28 patients with immature senile cataract. They were divided into two groups; in one group (17 eyes) intraoperative arcuate keratotomy was coupled with phacoemulsification in the steeper meridian (arcuate keratotomy group; mean preoperative astigmatism 2.28 ± 0.89 D) and the other group (17 eyes) phacoemulsification was performed in the steeper meridian without arcuate keratotomy (control group; mean preoperative astigmatism 2.04 ± 0.50 D). The patients were examined at 1 day, and 1, 4, and 8 weeks postoperatively. Correction of keratometric astigmatism, surgically induced refractive changes, magnitude and axis of cylinder, spherical equivalent refraction, with and against the wound change, and coupling ratio were evaluated. RESULTS: Mean reduction in keratometric astigmatism in the keratotomy group was 1.26 ± 0.54 D (P = .0067) and in the control group was 0.48 ± 0.60 D (P = .0423). The difference in reduction of keratometric astigmatism between the two groups was statistically significant (P = .0296). Surgically induced refractive change at 8 weeks follow-up was 2.15 ± 1.13 D in the keratotomy group and 1.50 ± 1.32 D in the control group (P = .046). Coupling ratio was -1.10 ± 0.43 in the keratotomy group at 8 weeks after surgery while the control group was -0.82 ± 0.38. CONCLUSION: A combination of intraoperative arcuate keratotomy with steep axis phacoemulsification incision is more effective than steep axis phacoemulsification incision alone in reducing pre-existing astigmatism. IJ Refract Surg 2002; 18: 725-730]

To test the efficacy of topical betaxolol to recover unexplained visual loss after uneventful cataract surgery in hypertensive patients. Study design: Randomized clinical trial. MATERIALS AND METHODS: One hundred patients of decreased visual acuity (20\40 to 20/50 after best correction after 6 weeks of uncomplicated small incision surgery in hypertensive patients were enrolled. Fifty eyes received topical betaxolol twice daily and fifty eyes received placebo eye drops as a randomized comparison group and followed up for more than six months. Change in best-corrected visual acuity was considered as change of five letters (0.1 log MAR) or more. Statistical analysis: Significance of difference of results between study and control groups is determined by Mann-Whitney U test and Fisher Exact test. RESULTS: 14 (28 %) patients demonstrated three lines and 31 (62 %) patients showed two line improvement in best-corrected visual acuity under treatment group. Whereas one (0.3 to 0.0) and 11 (0.4 to 0.2) eyes of the placebo group demonstrated same amount visual improvement. CONCLUSION: Topical betaxolol significantly improves visual acuity in unexplained visual loss after uneventful small incision cataract surgery in hypertensive patients.

BACKGROUNDBlindness has long been recognised as a public health concern in India. The study aimed to assess the burden of incurable blindness and explore the available and accessible rehabilitation measures in rural community. MATERIALS AND METHODSA cross-sectional study was undertaken among two blocks of West Midnapur district, West Bengal using a pre-designed, pre-tested semi-structured proforma by trained ophthalmologist from a Medical College Hospital. RESULTSThe study identified 212 eyes of 106 incurably blind individuals. Age range was 5-75 yrs. with median age of 22 yrs. Median duration was 18 years; 68 individuals were blind since birth (64.15%); 131 eyes (54.71%) had causes dating back to their birth or early childhood. Coloboma with microphthalmos were the leading cause accounting for 36 cases (16.98%). Congenital cataract 22 (10.37%), microphthalmos with microcornea 17 (8.01%) and nystagmus without ocular pathology 14 (6.60%) were other leading causes. Diseases acquired later childhood or adulthood accounted for 81 out of the 212 eyes (38.20%). Retinitis pigmentosa 18 (8.49%), bilateral keratitis 14 (6.60%), adult glaucoma 08 (3.77%) and high myopia with chorioretinal degeneration 08 (3.77%) were also found; 3 persons were admitted to blind school, 6 were receiving financial support but none aware of any Community Based Rehabilitation (CBR); 71 eyes (33.49%) out of 212 were lost from preventable causes of which 36/131 were (27.48%) in children and 35/81 (43.20%) in adult age groups. CONCLUSIONThe study highlights need for early screening and comprehensive rehabilitation approach to reduce the burden of incurable blindness in the community.