Purpose: To assess Photo Activated Chromophore for Infective Keratitis-Cross Linking (PACK-CXL) and its efficacy as a treatment modality in managing microbial keratitis. Methods: Single Centre prospective interventional study in infectious keratitis. A total of eleven patients were taken who had corneal thickness (CT) more than 400µm. PACK-CXL was performed according to Dresden’s protocol. The response was assessed by slit lamp examination, BCVA and AS-OCT at the time of complete healing. Results: The mean visual acuity at presentation was 1.207logMAR (0.3-3) which improved to mean value of 0.53logMAR (0.3-1). Mean time taken for complete epithelization was 17.45 days (14- 30 days) and that for complete healing was 33.72 days (21- 60 days). Mean CT at the baseline was 650.5± 108µm which reduced on consecutive follow up visits. There was reduction in the symptoms in nine patients except in two. One case reported increase in symptoms with worsening increase in endoexudates and hypopyon, and the other developed drug toxicity due to topical medications. Conclusion: Patients who underwent PACK-CXL showed good and early healing, good remodelling of cornea and improved visual acuity. The recalcitrant cases became responders to the same medications after PACK-CXL. Thus, PACK-CXL works well for both fungal and bacterial keratitis.

A novel entity of optic nerve retraction following blunt trauma in a young boy is reported. Rotational injury of the globe following a fall from a bicycle resulted in optic nerve retraction within the scleral canal. On fundus examination, the scleral rim was visible, with peripapillary and vitreous hemorrhage and associated retinal detachment. Computed tomography of the orbit on axial section revealed an intact optic nerve at the posterior surface of the sclera.

The intraocular pressure has been a subject of considerable speculation since it is the only modifiable risk factor for Primary Open Angle patients. This fluctuation follows a reproducible pattern in most of the eyes. However, there are some eyes which do not follow a consistent pattern of this fluctuation. The need to precisely measure this pattern stems from the fact that a single office based measurement could miss these pressure peaks. Recording the diurnal variation proves to be an effective tool in management of progression of Primary Open Angle Glaucoma as it not only identifies the time of the day when the pressure peaks to enable us to tailor the therapy to appropriately timing the drug administration but it also offers an understanding of range of intraocular pressure fluctuation during the day.