Aim: To compare visual outcome, postoperative surgically induced astigmatism (SIA), andpostoperative complications of superior and temporal scleral incision in manual small incisioncataract surgery (MSICS). Materials and Methods: A Prospective Randomized, parallel-group,active-controlled Trial Study of 80 cases of senile/pre-senile cataract. 40 cases were randomlyassigned (computer-generated randomization) to superior incision and 40 cases to the temporalincision. Results: The majority of patients (38 patients- 47.5%) were in the age group of 56-65years. The next common age group was 66-75 years(31 patients-38.75%). In the superior MSICSgroup, the majority of patients (28 patients-70%) had a moderate post-operative unaided visualacuity of 6/18-6/12. In the temporal MSICS group, majority of patients(33patients-82.5%) had agood post-operative unaided visual acuity of 6/9-6/6. The mean surgically induced astigmatism(SIA)in the superior MSICS group was 1.12 and in the temporal MSICS group was 0.45 with a differenceof 0.67. The SIA values were analyzed using the unpaired T-test which showed a value of 9.967which was statistically significant(P value of 0.0001). Conclusion: This study has shown that thetemporal approach for Manual small incision cataract surgery(MSICS) has less postoperativeastigmatism and better postoperative unaided visual acuity compared to the superior approach.

A dilemma exists in context to the timing of surgery in a case presenting with explosive onset seizures secondary to a focal cortical dysplasia (FCD). This case report highlights the challenges faced in the management of a 4-year-old child with recent onset cluster seizures refractory to anti-epileptic drugs. A 4-year-old girl presented with an acute onset of cluster seizures (up to 32 in a day), semiologically characterized by tonic upper limb extension and laughter lasting for few seconds with no response to multiple anti-epileptic drugs. The clinical, electrographic, neuroimaging and interictal positron emission tomography data were concordant and consistent with a left middle frontal gyrus dysplasia which was successfully resected under electrocorticographic guidance. Patient is seizure free at 2 months of follow up. (Engel Class 1). Surgical resection is feasible and potentially more effective in the early phase of clinical presentation of FCD.

No abstract

Aim: To study the relationship between Intra ocular pressure and refractive errors (myopia and hypermetropia) and assess glaucoma risk in middle aged adults and compare with a normal emmetropic population of same age group. Materials and Methods: This is a prospective observational study of 150 patients between the age of 30-50 years attending ophthalmology outpatient department of SRM Medical College Hospital & Research Centre for a period of 6months. They were categorized into five groups as Emmetropia (+0.5D to-0.5D), Hypermetropia(>+0.5D), Low Myopia (-0.75D to<-3D), Moderate Myopia (-3D to-6D) and High Myopia (>-6D). Intraocular pressure will be measured with Goldmann applanation tonometer three times at one weekly interval and the average value will be taken. Results: The intra ocular pressure in moderate and high myopia was found to be higher compared to emmetropic, hypermetropic and low myopic patients which was statistically significant (P value-0.0001). In all the refractive error groups, the intra ocular pressure was higher in the 40-50 years age group compared to the 30-39 years age group. There was no statistically significant difference between Intra ocular pressure in the right eye and left eye and between the sexes in all the refractive error groups. Conclusion: The intra ocular pressure was higher in moderate and high myopia and in the 40-50 years age group. This confirms that intra ocular pressure increases with advancing age. Patients with moderate and high myopia have increased risk of developing Glaucoma. Therefore, it would be advisable to routinely check intra ocular pressure for myopes.

The aim of the study is to evaluate hospital-based prevalence of dry eye in post-menopausal women, according to age, symptoms of dry eye and occupation. Materials and Methods: A cross-sectional study of 200 post-menopausal women attending ophthalmology outpatient department of SRM Medical College Hospital for 6 months. The diagnosis of dry eye was based on Schirmer's test. The value of < 5mm is considered severe dry eye, 5-8 mm is moderate dry Eye, 9-14 mm is mild dry eye and > 15 mm is normal. The results were analyzed using the Chi-square test. Results: The prevalence of dry eye in post-menopausal women was 52%. The prevalence of dry eye increases with age from 26.8 % (50-54 years) to 85.7% (>70years). The prevalence of dry eye in patients with symptoms of dry eye was 88% and without symptoms was 30.4%. The Schirmer`s test showed majority of patients had mild dry eye (27.5%) followed by moderate dry eye in 21%. The prevalence of dry eye with outdoor occupation was 64.4% compared to 41.8% for indoors. Conclusion: The prevalence of dry eye in this study was high. Even patients without symptoms of dry eye can have subclinical dry eye. Patients with outdoor occupation had a higher prevalence of dry eye. Simple treatment with artificial tear substitutes can effectively manage mild and moderate dry eye and help post-menopausal women in improving their quality of life. It would be advisable to screen all post-menopausal women for dry eye using a simple Schirmer`s test.