Background: Visual disability has deep emotional, social and economic impact. Rehabilitation of these individuals needs multidisciplinary approach to provide timely and complete support and improve the quality of life of the individual. Visual disability certification can be recognized as a mean by which social services of visually disabled can be coordinated. Objective was to analyze the demographics, causes and degree of visual disability and reasons of seeking disability certificate amongst visually disabled individuals attending ophthalmology OPD at a Tertiary Care Centre in India.Methods: A cross sectional study of patients seeking visual disability certificate was undertaken on 350 patients (567 eyes). Data were collected using pre set proforma. Cause of blindness was ascertained by complete ophthalmic examination and visually disability certificate was issued according to guidelines provided by Government of India.Results: Male female ratio was 1.9:1. Most of patients were from rural side, illiterate and unemployed. Most common age group was 16-30 years and financial and transport assistance was common reason for which certificate was sought. Corneal opacity was most common cause of blindness and visual impairment.Conclusions: Taking necessary preventive measures with the leading causes being identified can reduce the burden of visual impairment. On one hand increase in ophthalmic care and public education is needed to minimize the avoidable blindness rates ;on other hand strategies should be made to rehabilitate the individuals suffering from the unavoidable blindness. Benefits provided via visual disability certificate can play a pivotal role in rehabilitation of such patients.

BACKGROUND: Human immune deficiency virus (HIV) causes a wide spectrum of diseases worldwide and has the capability to affect every organ system in the body. Ocular manifestations have been reported in up to 70% of individuals infected with HIV and the ocular manifestations reflect systemic disease and maybe the first sign of disseminated infection. PURPOSE: To study the pattern of ocular manifestations related to HIV in seropositive patients with the objective of identifying its spectrum in highly active antiretroviral therapy (HAART) era and to emphasize on the role of ophthalmologists in fighting the battle against HIV. MATERIALS AND METHODS: A cross sectional study was undertaken on 300 HIV positive patients. Data were collected, tabulated and analyzed using MSTAT software. Chi-square test was applied and P < 0.05 was considered significant. RESULTS: Ocular lesions were observed in 50.33% of patients. Conjunctival microvasculopathy being the most common finding seen in 27 (9%) patients, followed by retinal microvasculopathy and trichomegaly in 20 (6.66%) patients each. Herpes zoster ophthalmicus and cytomegalovirus retinitis were observed in four (1.33%) and three (1%) patients respectively. In the study 78.33% patients were on ART. CONCLUSION: HAART has reduced serious ocular opportunistic infections and ocular malignancies, but HAART mediated visually disabling immune recovery uveitis has emerged as a clinical challenge for ophthalmologists. Improved communication between the two broad specialties of HIV medicine and ophthalmology will definitely go a long way in the battle against this dreadful disease.

IntroductionMucormycosis (black fungus) is a rare opportunistic fungal infection commonly affecting immunocompromised individuals. There has been a surge in the number of these cases during the second wave of the coronavirus disease 2019 (COVID-19) in India. Mucormycosis has been reported to occur within a week or a few weeks post-recovery from COVID-19. The most common clinical manifestation of mucormycosis is rhino-orbital-cerebral mucormycosis (ROCM). At our tertiary care center, we initiated a prospective study to identify risk factors, study ocular manifestations, and explore medical and surgical management of orbital mucormycosis patients in the post-COVID-19 era. Material and methodsThis is a detailed description of a prospective observational hospital-based study. The study included 148 patients who presented with ROCM. A detailed history was taken regarding the complaint, duration, and associated risk factors. Systemic, local, and complete ophthalmic examinations were done that included assessment of extraocular movements, visual acuity, slit-lamp examination, and fundus examination. All data were recorded separately for each patient in a pre-decided proforma. ResultThe study group consisted of 148 patients. In our study, the highest association was with COVID-19-positive status (68.24%), out of which 57 (56.43%) were on oxygen support. Diabetes mellitus contributed next to COVID-19 with 86 (58.10%) patients with a positive history of diabetes. Seventy-one (47.97%) patients were on steroids, out of which 68 (67.32%) were COVID-19-positive and the rest (23%) were on steroids due to various systemic reasons. Rhinomaxillary involvement was present (51%). Out of 63 patients with orbital involvement, 16 (25.39%) presented bilaterally and 47 showed unilateral orbital involvement more on the right side (42.85%). The predominant location of orbital involvement was the orbital apex. The most common symptom seen in our study was nasal discharge (86.5%), and ophthalmoplegia was the most common sign. ConclusionCorticosteroids should be used with caution to prevent negative impact and potential ROCM. Good glycemic and metabolic control is crucial for treatment. Management of mucormycosis involves surgical debridement, antifungal agents, and retrobulbar amphotericin B injections. Early diagnosis and aggressive treatment are essential for success. Orbital exenteration may be necessary for advanced stages, while conservative approaches may work for earlier stages. Patient counseling is needed for cosmetic rehabilitation. A multidisciplinary approach involving various specialists is necessary.

PURPOSE: To evaluate intraocular pressure (IOP) control, visual prognosis, and complications following phacoemulsification in eyes with phacomorphic angle closure of <10 days’ duration. METHODS: Prospective, nonrandomized interventional consecutive case series included all patients with phacomorphic glaucoma who presented between November 2020 and November 2021. All patients underwent slit-lamp biomicroscopy, applanation tonometry, and gonioscopy of the other eye. Phacoemulsification with IOL implantation under topical anesthesia was performed in all cases. A complete ophthalmic examination was done at each follow-up visit. RESULTS: A total of 50 eyes with phacomorphic glaucoma were included in this study. The preoperative mean IOP was 41.12 ± 8.20 mmHg and the mean IOP at last visit was 13.84 ± 2.08 mmHg. There was a statistically significant difference between IOP at presentation and IOP at last follow-up ( P < 0.001) (Wilcoxon Signed-Ranks Test). There was no requirement of long-term anti-glaucoma medications in any patients. No significant intraoperative complications were noted. The final postoperative best-corrected visual acuity was 6/12 or better in 32 patients. Sixteen eyes had corneal edema and 20 eyes had anterior chamber inflammation on postoperative day one that resolved with standard medical therapy. CONCLUSION: Phacoemulsification is safe and effective in controlling IOP and achieving good functional visual acuity with minimal complications in the management of phacomorphic glaucoma in expert hands. Our study also lays emphasis on public awareness, early detection, and management of advanced cataract, so that the incidence of this potentially blinding entity can be reduced.