To compare the efficacy and safety of sutureless glue-free versus suture technique for autogenous conjunctivolimbal grafting in primary pterygium excision. A prospective observational study was conducted in thirty consecutive patients of primary progressive pterygium after taking their informed written consent and ethical clearance in a tertiary eye care centre of Northern India. Patients were randomly divided equally into group “A” and “B” each constituting fifteen patients. Group A patients underwent suture technique and group “B” patients underwent sutureless technique for conjunctivolimbal graft placement. Comparison of both groups was done in terms of intraoperative time, postoperative symptoms and recurrence over a period of one year. Data was compiled and entered into Microsoft Excel software and SPSS version 21.0 was used for data analysis.The mean duration of surgery was 42 min and 30 min in group A and B respectively and this difference was found to be statistically significant (p=0.0001). On 1 postoperative day, pain and foreign‐body sensation was present in 12 patients in group A, while only 1 patient of group B had these symptoms and this difference was statistically significant (p = 0.00014). Postoperative hyperaemia was seen in 8 patients of group A and 6 patients of group B which was statistically insignificant (p = 0.564). Only two patients in group A had conjunctival chemosis while no patients in group B developed chemosis, and the difference was statistically insignificant (p = 0.964). Subconjunctival haemorrhage was seen in 2 patients of Group A and 1 patient of Group B which resolved over a period of 2-3 weeks. Conjunctivolimbal graft was found to be more stable in group A while it was misplaced in 1 patient of group B and the difference was statistically insignificant (p = 1.000). Only 1 patient of group A developed suture related complication i.e suture granuloma. Over a period of 1 year follow up, only 1 patient of group A had recurrence of pterygium.Sutureless glue-free technique is a time saving, cost effective and better surgical modality in comparison to conventional suture technique for autogenous conjunctivolimbal grafting in primary pterygium resection.

Background: Diabetes mellitus (DM) affects the corneal endothelium by altering the function of Sodium Potassium ATPase activity, thus causing functional changes in diabetic corneas. Associated structural changes if any are important to be recognized timely since it has multiple clinical implications. A few studies have studied corneal morphological changes, including endothelial morphology and corneal thickness in diabetic subjects but it is still a topic of research and there are not many Indian studies in literature. Aim: 1) To analyze central corneal thickness (CCT) in subjects with diabetes mellitus and to compare this with age and sex matched healthy controls. 2) To correlate the association between CCT and duration and severity of diabetes. Methods: This was a cross-sectional study conducted in the diabetic patients of the age group of 18-76 years presenting to the Medicine department of the hospital. Eighty six subjects with Type-II DM and eighty six age matched controls were included in the study and were undertaken for CCT measurement by Ultrasonic pachymeter. Results: CCT significantly increased in diabetes (559.48±31.29) as compared to controls (534.61±34.55). Positive correlation was found between CCT and disease duration ≥ 10 years, HbA1c≥7 gm% and presence of diabetic retinopathy. Conclusion: CCT could assist in early identification of diabetics with higher risk for systemic and ocular complications, thus enabling better control of disease.

Purpose: To analyse demographic data, clinical presentation, intervention and management of Post COVID 19 Rhino- orbito-cerebral- mucormycosis (ROCM) thus improving the knowledge about the disease to provide timely and optimal care for favorable outcome. Method: A retrospective interventional study was conducted on 254 patients admitted in Mucor ward over a duration of 2 months (1st May 2021- 30th June 2021). Demographic data, detailed history, clinical parameters, diagnostic procedures, management and outcome were noted. Factors affecting outcome and mortality were analysed. Results: Mean age of presentation was 50.14 ±13.38 years with male preponderance (64.56%). 55.91% patients presented with ROCM symptoms within 14 days of onset of COVID -19 symptoms. 86% patients were diabetics, 76% had history of corticosteroid use and 27.55% received oxygen therapy. 40 % patients presented with orbital edema as primary symptom. Imaging revealed 28.34% patients had disease limited to the paranasal sinuses (PNS), 56.69% had orbit and PNS involvement and 12.99% had PNS, orbit and CNS involvement. All the patients were treated with Liposomal Amphotericin B and sinus debridement. Eighteen eyes underwent (7.08%) exenteration and 82 patients received Transcutaneous retrobulbar Amphotericin-B. At the time of discharge the final outcome of being alive and having stable disease was found to be significant in stage 2 patients with involvement of PNS and orbit. Conclusion: Awareness of red flag symptoms and signs, high index of clinical suspicion, prompt diagnosis, and early initiation of treatment with Amphotericin B, aggressive surgical debridement of the PNS, and orbital exenteration, where indicated, are essential for successful outcome.

Objective This study aims to formally evaluate near-peer-assisted learning (NPAL) for teaching clinical ophthalmology skills to second-year undergraduate medical students through their fellow medical interns. Methods Interns posted at the department of ophthalmology were included as tutors after an initial sensitization and assessment. Second-year undergraduate students were included as tutees. Sessions were conducted for pre-identified clinical skills in batches of 3–5 tutees each. Perceptions of tutors and tutees were captured on a 5-point Likert scale (Kirkpatrick level-1) and evaluated. Tutors were assessed by directly observed procedural skills (DOPS) and tutees by pre- and post-session scores and performance of the respective clinical skills (Kirkpatrick level-2). Results A total of 21 of 24 tutors and 82 of 100 tutees responded to the evaluation questionnaire. Tutors perceived themselves as knowledgeable and useful as instructors; scores of second DOPS session significantly improved compared to the first (p = 0.001) for all clinical skills. Tutees found the NPAL sessions effective for learning clinical skills. Pre- and post-test scores significantly improved (p = 0.001), and all clinical skills were satisfactorily performed in the end-of-term exam. Conclusion NPAL was perceived as an effective teaching-learning method by both tutees and tutors, and all clinical skills were performed successfully. NPAL can serve as a useful adjunct to traditional teaching for clinical training of small groups and can help alleviate teaching pressures on already burdened clinical faculty in Indian Medical colleges.

Background: The Rashtriya Bal Swasthya Karyakram (India) is directed towards achieving universal health coverage among children by early detection of diseases. Under the scheme, children are screened at the level of schools and community and are thereafter referred to tertiary centre. The purpose of study was to identify common causes of ocular morbidity in children screened and referred through this national screening program. Methods: Retrospective analysis of records of all children who presented to our centre with ocular problems over a period of one year (2015) was undertaken. Clinical diagnosis was recorded on a seven point scale based on major anatomical involvement. An analysis of causes of visual impairment was undertaken with a special emphasis on avoidable and treatable causes. Results: A total of 851 subjects presented with ocular problems (mean age 9.5±4.9 years); of them 819 were classified into seven major clinical groups and subgroups. Most common clinical group was that of strabismus (59.9%), followed by refractive errors (16.9%), lids related disorders (6.2%), orbit and adnexal developmental defects (4.6%), lenticular (3.3%), corneal and conjunctival (3.2%) and retinal disorders (2.1%). A total of 49.7% cases had avoidable or treatable causes of visual impairment. Conclusion: A national program with capacity to screen and ensure appropriate referral facilities resulted in intervention in many cases with avoidable and treatable causes of visual impairment. A varied pattern of ocular morbidity was found among the referred cases; our study could provide a platform for a target oriented approach towards planning and implementation of such screening programs.