BACKGROUNDChildhood ocular trauma is an important cause of disabling ocular morbidity. One third of the ocular trauma causing loss of vision is limited in the first decade of life. Children are more commonly affected because of their underdeveloped motor skills and high curiosity. Visual prognosis of severe ocular trauma is really challenging in paediatric age group. We wanted to study the causes and types of paediatric ocular injuries clinically. We also wanted to study the causes and types of ocular injuries in different ages, sexes, with an urban-rural distribution. among two hundred (n=200) number of patients up to 15 years of age. A detailed clinical and ophthalmological examinations were done in every patient. RESULTSFall from a height (40%) and fingernail (19%) trauma were the most common causes of ocular injuries, followed by blouse hook (17%) injuries during breastfeeding, pencil and pen related trauma (11%) and fall on the rocks (13%). Other findings were corneal abrasion (28%), eyelid swelling (23%) and bruise (21%). Fracture of orbital wall (7.5%), sub conjunctival haemorrhage (19%), corneal perforation (6%), hyphema (4%), iris injury (6%), intraocular foreign body (10%) and globe rupture (3%). Posterior segment involvement was rare. CONCLUSIONSChildren should be away from the traumatic agents as much as possible. Parents should be trained properly for early management before coming to the hospital. Creation of more referral centers for ocular emergency should be far from the urban areas for giving early management to the traumatized children to avoid visual morbidity as much as possible.

BACKGROUNDAnkylosing spondylitis (AS) is a chronic inflammatory systemic disorder affecting the axial skeleton with chronic pain and stiffness in the lower back or buttocks region and progressive limitation of spinal movements. Many patients exhibit extra-articular manifestations and anterior uveitis is a common form of extra articular manifestation of AS. Other findings are episcleritis, scleritis, peripheral ulcerative keratitis, retinal vasculitis, dry eye, cataract and secondary glaucoma. Sometimes ocular signs are the only presentation. It is very challenging for an ophthalmologist to carefully examine the patients of AS so that permanent bony deformity is minimised. We wanted to evaluate the magnitude of ocular manifestations in patients suffering from AS and establish the statistical significance of age of patients and determine the frequency of ocular manifestations for epidemiological purposes. METHODSThis is a cross sectional observational study done among one hundred and forty-four patients (n=144) with AS conducted between December 2018 and July 2019. Slit lamp biomicroscopy with 90 D Volk lens was done for anterior and posterior segment examination. Gonioscopy, Applanation Tonometry, Automated Perimetry and Indirect Ophthalmoscopy were done. Schirmer's and TBUT tests were done. RESULTSAnterior uveitis (30%) was the most common ocular manifestation followed by vitritis (18%), cataract (15.2%), episcleritis and scleritis (7.6%), dry eye (6.2%), retinal vasculitis (8%) and peripheral ulcerative keratitis (5%). Males are more commonly affected. The duration of disease was found to be statistically significant (p<0.001) when correlated with age groups with patients in the age group of >60 years and with respect to unilateral/bilateral presentation of ocular manifestations (p=0.016). CONCLUSIONSOphthalmologist has a great role for diagnosing of AS. Patients usually come to ophthalmology OPD for management of ocular symptoms with undiagnosed AS and physician must be cautious while assessing ocular signs and symptoms for suspecting AS. As a result, irreversible bony deformities can be minimized as much as possible.HOW TO CITE THIS ARTICLE: Babu SS, Maiti P, Islam MN. Ankylosing spondylitis: ophthalmologist plays a major crucial role!.

BACKGROUND Snake bite is a common and dangerous public health problem. It evokes primordial fear in human beings. Still the public health importance of snake bite has widely been neglected. Though ophthalmological manifestations are uncommon, there are very few community-based surveys on ocular manifestations related to haemotoxic snake bite in West Bengal. We wanted to assess the prevalence and pattern of ocular morbidity due to haemotoxic snakebite among the patients in a tertiary care hospital and evaluate the causes of vision loss following haemotoxic snakebite in rural West Bengal. METHODSOne hundred and ten patients (n=110) of haemotoxic snake bite cases admitted at R G Kar Medical College have been studied between February 2018 to January 2019. All the admitted patients were initially managed in the Medicine department and ocular examination was done after stabilization of the patients. This is a cross sectional observational study. RESULTSMales were the most common victims. Sub conjunctival haemorrhage (10%) followed by acute anterior uveitis (7%) was the most common anterior segment finding. Cotton wool spots and retinal haemorrhage were the most common posterior segment findings. Other findings were chemosis, episcleritis, scleritis, eyelid swelling, keratomalacia, endophthalmitis and angle closure glaucoma. Other findings were vitritis, vitreous haemorrhage, macular infarction, central retinal artery occlusion, exudative retinal detachment and optic disc swelling. One case of direct ocular injury was seen from ocular bite resulting in conjunctival and corneal laceration. CONCLUSIONSIt is very essential to limit the vision loss and minimize the ocular side effects especially in rural hospital. It is very challenging and special training to ophthalmologist at primary level may be necessary for diagnosis and management of such type of cases. HOW TO CITE THIS ARTICLE:Babu SS, Islam MN, Maiti P. Haemotoxic snake bite-how challenging for an ophthalmologist!