For centuries arsenic has played an important role in science, technology, and medicine. Arsenic for its environmental pervasiveness has gained unexpected entrance to the human body through food, water and air, thereby posing a great threat to public health due to its toxic effect and carcinogenicity. Thus, in modern scenario arsenic is synonymous with “toxic” and is documented as a paradoxical human carcinogen, although its mechanism of induction of neoplasia remains elusive. To assess the risk from environmental and occupational exposure of arsenic, in vivo cytogenetic assays have been conducted in arseniasis-endemic areas of the world using chromosomal aberrations (CA) and sister chromatid exchanges (SCE) as biomarkers in peripheral blood lymphocytes. The primary aim of this report is to critically review and update the existing in vivo cytogenetic studies performed on arsenic-exposed populations around the world and compare the results on CA and SCE from our own study, conducted in arsenic-endemic villages of North 24 Parganas (district) of West Bengal, India from 1999 to 2003. Based on a structured questionnaire, 165 symptomatic (having arsenic induced skin lesions) subjects were selected as the exposed cases consuming water having a mean arsenic content of 214.96 µg/l. For comparison 155 age-sex matched control subjects from an unaffected district (Midnapur) of West Bengal were recruited. Similar to other arsenic exposed populations our population also showed a significant difference (P < 0.01) in the frequencies of CA and SCE between the cases and control group. Presence of substantial chromosome damage in lymphocytes in the exposed population predicts an increased future carcinogenic risk by this metalloid.

This is a rare association and, to the best of our knowledge, the first report of successful treatment with dimercarpol. The source of arsenic was contaminated underground drinking water (from a deep tube-well). The pathophysiology is thought to be the result of an inflammatory response caused by accumulated arsenic in local tissues. Papillary conjunctivitis and dermatological changes can be successfully managed with dimercaprol and multivitamins. Further studies are required to find out the possible link between the papillary response of conjunctiva and arsenic accumulation within the body.

A 43-year-old man developed central serous choroidoretinopathy in his left eye following dacryocystorhinostomy operation on the same side. He was using xylometazoline nasal drops in his left nostril. Action of xylometazoline or the stress related to the operation or the effect of both factors played the role in the causation of this ocular condition. Omission of nasal drops or relief from stress resulted in full recovery of vision and complete resolution of symptoms within one month.

Brucellosis is endemic to India but remains highly underdiagnosed. We report an unusual case of intermediate uveitis with Brucella etiology (BE). A 45-year old female from eastern India complains of diminution of vision and floaters in both eyes (BE), worsening over the last 6 months. Previously, she received on and off oral steroids for 2 years. Her BCVA in right eye (RE) was 20/160 and left eye (LE) was 20/200. She had old keratic precipitates, posterior subcapsular cataract, and vitritis in BE. On ELISA, she was positive for Brucella IgM antibodies. Subsequently, oral antibiotics improved her vision. Ocular involvement in brucellosis, can cause severe vision-threatening complications. An early diagnosis of brucellosis can thus save sight.

BACKGROUND The purpose of this study is to assess efficacy of laser photocoagulation monotherapy, intravitreal Bevacizumab monotherapy and combined therapy (laser photocoagulation and intravitreal Bevacizumab) on the basis of mean average change in BCVA and changes in macular thickness over 6 months in DME ≥ 350 µm. This is to identify the best treatment option in Non-Proliferative Diabetic Retinopathy (NPDR) with macular thickness ≥ 350 µm in type 2 diabetic retinopathy patients. Design-An open label, randomised, parallel group, comparative trial. MATERIALS AND METHODS In this study, Best Corrected Visual Acuity (BCVA) and macular thickness (CFT) was compared before and after modified macular grid laser monotherapy, intravitreal Bevacizumab injection monotherapy and combined therapy in patients with macular oedema with thickness ≥ 350 µm measured with spectral domain OCT. One hundred and twenty (120) newly diagnosed eyes of NPDR with macular oedema (40 patients in each group, age and sex matched) attending retina clinic of Regional Institute of Ophthalmology, Kolkata, over a period of one year (01/09/2013 to 31/08/2014) were included in this study. Patients having bilateral macular oedema were treated with one group of therapy in one eye and another group of therapy in other eye. We have considered newly diagnosed non-ischaemic non-proliferative diabetic retinopathy eyes with macular oedema of ≥ 350 µm. RESULTS Mean CFT at the start of the treatment, i.e. the baseline was statistically insignificant in between and within the three groups, but it became significant at 1 month (p = 0.0001), at 3 months (p = 0.0001) and at 6 months (p = 0.0001) using One-Way ANOVA. Therefore, there is significant difference in the improvement achieved at 1 month, 3 months and 6 months in CMT within the three groups and also between the three groups. Mean BCVA at the start of the treatment, i.e. the baseline was statistically insignificant in between and within the three groups, but it became significant at 1 month (p = 0.001), at 3 months (p = 0.0001) and at 6 months (p = 0.0001) using One-Way ANOVA. Therefore, there is significant difference in the improvement achieved at 1 month, 3 months and 6 months in BCVA. CONCLUSION This parallel group comparative trial has shown that Intravitreal Bevacizumab is most effective in reducing the central macular thickness followed by combined treatment and then modified grid laser treatment. This study has also shown that Intravitreal Bevacizumab is most effective in improving the best corrected visual acuity.