The pandemic has forced the health-care system to adopt newer approach toward patient care. With the changing scenario of health-care delivery, ophthalmologists had to bring about several changes in the way, the patients are seen and operated on. Contact procedures were entirely restricted to emergencies while modifications were introduced to minimize the exposure of the surgeon. However, these modifications were introduced just keeping in mind the spread of infection. The probability that these modifications could affect the optics in ophthalmology is high and cannot be ruled out. The aim of the study was to highlight the effects of modifications introduced in ophthalmic equipment during the pandemic over the visibility for the surgeon and discuss its impact on patient care in ophthalmology. Thorough search of the literature on PubMed using keywords, visibility and personal protective equipment (PPE), fogging and PPE, face mask and fogging, aberrations and PPE, and surgeries and PPE were done. We found 35 articles which highlighted the effects on visibility with PPE and effects on eyes with prolonged wearing of masks. Several factors have contributed to reduction in visibility for the surgeon. These factors have, in turn, affected the overall quality of examination and surgical outcome in ophthalmology. The use of PPE during the pandemic could have been a contributory factor for missing relevant findings during examination of patients. For ophthalmologists in particular, the visibility and optics play a crucial role in the management of the patient and have been invariable affected by introduction of modifications at the instrument and surgeon level.

Objective To report a case of post radial keratotomy (RK) cataract in a 55-year-old lady wherein biometry was done by ray-tracing method incorporated in scheimpflug topographer (Sirius + Scheimpflug Analyzer, CSO, Italy). Method In our case, we performed intraocular lens (IOL) power calculation using a recent concept of ray tracing with scheimpflug topographer and compared with traditional methods available at American Society of Cataract and Refractive Surgery(ASCRS) website ( www.ascrs.org ) for eyes with prior RK. Phacoemulsification was performed and a monofocal + 24.5D IOL implanted in the capsular bag. Result Manifest refraction at six weeks postoperative period was + 1.0DS/-2.0DC × 75° with spherical equivalence of 0. On comparison of all the methods used to calculate IOL power, the absolute errors of ray tracing and Barrett true K were found to be the least, 0.14 and 0.18 respectively. Conclusion Ray tracing biometry with scheimpflug topographer seems to provide accurate IOL power in post RK eyes.

Rifabutin is a known-drug prescribed for prophylaxis and treatment of Mycobacterium avium complex (MAC) and causes dose-related anterior uveitis in immunocompromised individuals, particularly, those infected with HIV. Previous studies have reported rifabutin-induced uveitis with high doses. It is infrequent with 300 mg/day or less; moreover, it takes weeks to months to develop. We report three HIV cases that on treatment with low-dose 300 mg rifabutin presented with anterior uveitis with early occurrence. Furthermore, one of the cases had rifabutin-induced panuveitis, another rarity. Thus, although rare, low-dose rifabutin-induced uveitis with early presentation should be kept as a differential diagnosis of unusual presentation of uveitis in HIV, early management of which prevents visual morbidity.