To compare the blood agar (BA), sabouraud dextrose agar (SDA) and chocolate agar (CA) for the isolation of fungi in patients with mycotic keratitis. Corneal Scrapings of 229 patients with clinically diagnosed microbial keratitis were inoculated on BA, SDA, CA. The culture media were evaluated for the rate and time taken for the fungal growth. Seventy six of 229 patients had fungal keratitis. Fungus grew on BA in 60/76(78.9 %), on SDA in 76/76 (100 %), on CA in 40/76(52.6 %) patients. The fungi which grew on BA (60/76) also grown on SDA at the same time. The colony morphologies of different fungi were better on SDA than BA/CA. Among the different culture media, SDA is essential for the isolation fungi in patients with mycotic keratitis.

Fungal keratitis due to Schizophyllum commune is very rare. In this study, we report the clinical and microbiological profile of five patients with fungal keratitis due to S. commune. Direct microscopic examination of corneal scrapings from all five patients showed septate branching hyaline fungal filaments. Similarly, in all five patients Sabouraud dextrose agar (SDA) plates inoculated with corneal scrapings showed white, cottony colonies on the second day of incubation. Lactophenol cotton blue stained wet preparation of 7-day-old colonies on SDA revealed clamp connections and no spores. The fungus was identified by its characteristic clamp connections, fan-shaped bracket fruiting body with pinkish-grey longitudinally split-radiating gills. The phenotypic identification of one of the five isolates further conformed by ITS sequencing. Treatment outcome was available for two of the five patients; in these two patients, the keratitis resolved with topical natamycin.

Diabetic peripheral neuropathy (DPN) is a difficult diagnosis to make, especially in its early stages. Standard practice has been to take judicious clinical history and examination with 10gm monofilament, which not only misses the early disease but also lacks the ability to detect small fibre neuropathy. Given the morbidity, mortality, as well as the cost implications diabetic foot ulcer disease has, it is crucial to diagnose DPN early to prevent the complications associated with it. Here, we discuss the utility of corneal confocal microscopy as a potential tool for early diagnosis of DPN, quantify its severity, and assess therapeutic benefit to identify nerve fibre repair in the context of disease modifying treatments of DPN. Copyright © 2021 John Wiley & Sons.

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Keratoconus is a corneal thinning disorder in which the inferior paracentral cornea thins and protrudes forwards. The onset is usually during the second decade. Blurred vision and frequent changes of spectacle power are the common presenting symptoms. In addition to heredity, there seems to an association of eye rubbing and development of keratoconus. Slit lamp examination and topographic evaluation helps to us detect early keratoconus, assess severity of keratoconus and decide management options. Keratoconus seems to be associated with other eye conditions like eye allergy, retinitits pigmentosa, Leber’s optic atrophy and also with systemic conditions like Marfan’s syndrome and Ehler Danlos syndrome. Rigid gas permeable (RGP) lenses are recomended contact lenses in keratoconus patients with mild to moderate astigmatism. Piggy back contact lens, softperm lens and scleral lens RGP lenses can be used in large ectasia. Implatation of PMMA (polymethylmethacrylate) intracorneal rings into the paracentral cornea has been found successful to reduce the spherical power and astigmatism. Since endothelium is relatively healthy, deep anterior lamellar keratoplasty is becoming the surgery of choice for patients who are not having good vision with contact lens or are not able to tolerate contact lens. Full thickness corneal transplantation (PK) is suggested in patients with dense central scar which is deeper and involving the Descemet’s membrane. Toric implantable contact lens (ICL) is useful if the keratoconus is stable or is the progression is arrested by doing collagen cross- linking or the irregular astigmatism is reduced following implantation of intracorneal ring. Keywords: keratoconus; keratoplasy; management; DALK surgery