AIM: To share clinical pattern of presentation, the modalities of surgical intervention and the one month post-surgical outcome of rhino-orbito-mucormycosis (ROCM) cases. METHODS: All COVID associated mucormycosis (CAM) patients underwent comprehensive multidisciplinary examination by ophthalmologist, otorhinolaryngologist and physician. Patients with clinical and radiological evidence of orbital apex involvement were included in the study. Appropriate medical and surgical intervention were done to each patient. Patients were followed up one-month post intervention. RESULTS: Out of 89 CAM patients, 31 (34.8%) had orbital apex syndrome. Sixty-six (74.2%) of such patients had pre-existing diabetes mellitus, 18 (58%) patients had prior documented use of steroid use, and 55 (61.8%) had no light perception (LP) presenting vision. Blepharoptosis, proptosis, complete ophthalmoplegia were common clinical findings. Seventeen (19.1%) of such patients had variable amount of cavernous sinus involvement. Endoscopic debridement of paranasal sinuses and orbit with or without eyelid sparing limited orbital exenteration was done in most cases, 34 (38.2%) patients could retain vision in the affected eye. CONCLUSION: Orbital apex involvement in CAM patients occur very fast. It not only leads to loss of vision but also sacrifice of the eyeball, orbital contents and eyelids. Early diagnosis and prompt intervention can preserve life, vision and spare mutilating surgeries.

BACKGROUND The aim of the study is to evaluate the change in macular thickness by optical coherence tomography after uncomplicated phacoemulsification versus uncomplicated manual SICS in known diabetic patients.

BACKGROUNDDissociated Vertical Deviation (DVD) is a poorly understood supranuclear strabismic disorder in which there is slow upward and sometimes temporal movement of one eye with cortical suppression of vision in that eye when it is occluded. In DVD, one eye get dissociated from the fellow eye, so they don't follow Hering's and Sherrington's laws of innervation. DVD is also a marker of disruption of normal binocular function, which causes unbalanced input to vestibular system resulting in latent nystagmus with a cyclovertical component. To overcome this cyclovertical component, vertical vergence is invoked for which vision is aided in the fixing eye, but unfortunately it also produces DVD of the fellow eye. DVD is most commonly associated with infantile esotropia. AIM To determine whether age of onset of strabismus is related to the development of dissociated vertical deviation in patients with horizontal concomitant heterotropia (HCH).To find out the occurrence of dissociated vertical deviation among patients with horizontal concomitant heterotropia and also to calculate how many of them is suffering from refractive error.  DESIGN This is a cross-sectional, observational hospital-based study. MATERIALS AND METHODThis study was done in 100 children presenting with horizontal concomitant heterotropia randomly chosen in the age group 5 yrs.-19 yrs. attending outpatient department and squint clinic of Regional Institute of Ophthalmology, Kolkata. After taking proper history regarding time of onset of strabismus, age of onset of DVD, they underwent a full ophthalmic examination including visual acuity assessment, cycloplegic refraction, assessment and measurement of squint and DVD, and stereopsis. RESULTMean age of horizontal concomitant heterotropes was 9.28 yrs. ± 3.94 yrs. of which 48% were male and 52% were female. Among horizontal concomitant heterotropes 24% were exotropes and 76% esotropes. The mean age of onset of strabismus in horizontal concomitant heterotropes leading to the development of DVD was 7.93 yrs. ± 9.95 yrs. Dissociated vertical deviation was present in 14% of horizontal concomitant heterotropia of which 78.57% were male and 21.43% were female. We found that 78.58% of DVD patients were having some type of refractive error. CONCLUSIONThis clinical study is a small endeavour on our part to suggest an earlier age of onset of strabismus is associated with higher chances of development of dissociated vertical deviation and we have also noticed a higher incidence of DVD in infantile esotropia.

BACKGROUND The purpose of the study was to determine the epidemiology, aetiology and pattern of penetrating ocular trauma in Kolkata and surroundings. MATERIALS AND METHODS It was a retrospective study of patients with open globe injuries who underwent surgery from July 2015 to June 2016 at Regional Institute of Ophthalmology, Calcutta Medical College, West Bengal. We examined and classified the injuries based on BETTS (Birmingham eye trauma terminology system). We included 192 eyes from 192 patients. The majority of injuries occurred in young (48% patients were <16 years). 54.17% patients were male and 45.83% were female. Most common mode of trauma was Stone (52), Followed by Iron Rod or Piece (44) and Wood (32). Other causes were Cow's horn (14), Needle (12) Knife (8), Arrow (6), Sickle (6), Rubber Tube (4), Glass (2), Crackers (4), Metal Instrument (2), Bird Beak (2) and Pencil (2). RESULTS The highest proportion of injuries occurred at home followed by outside. According to BETTS, 61 patients had zone 1, 29 patients-zone 2, 6 patients-Zone 3 injury. Associated features were iris prolapse, hyphaema, anterior capsular rupture, lid tear and impacted foreign body. Mean period of presenting at hospital was 2.72 days. Most common visual acuity at presentation was less than 6/60 to perception of light. CONCLUSION In our study, serious ocular trauma frequently occurred at home followed by outside and the young were particularly at risk. Most common mode of trauma was stone. Most of the injuries were limited to cornea up to limbus. More adequate adult supervision and educational measures are necessary in order to reduce the prevalence of these accidents.

Introduction: Emergence and subsequent exponential spread of Coronavirus Disease-2019 (COVID-19) infection during 2020 forced the Government to issue countrywide lockdown from March 2020. Diabetic Retinopathy (DR) is one of the debilitating diseases of the eye which requires regular follow-ups and timely intervention to prevent permanent vision loss. The impact of countrywide lockdown on prevalence and progression of DR needs to be evaluated. Aim: To assess the effect of COVID-19 pandemic situation on the prevalence and progression of DR and analyse the possible risk factors for progression of DR in the ongoing pandemic period by comparing retrospective data from immediate prepandemic quarter with post lockdown quarter. Materials and Methods: This retrospective study was conducted in the Department of Opthalmology at Regional Institute of Ophthalmology, Kolkata, West Bengal, India. The study was done during the prepandemic period, from November 2019 to February 2020. In the present study, a cohort of 83 diabetic patients with pre-existing DR was selected from past medical records and compared with post lockdown period during November 2020 to February 2021. Data regarding prevalence of various types of DR, mean Central Macular Thickness (CMT), mean Visual Acuity (VA), proportion of patients requiring >3 doses of monthly anti-Vascular Endothelial Growth Factors (VEGF) and additional laser therapy or vitrectomy, VA improvement and reduction of mean CMT were gathered and compared between those two quarters. The data was analysed using Statistical Package for Social Sciences (SPSS) version 25.0. Results: The prevalence of moderate Non Proliferative Diabetic Retinopathy (NPDR) (13% vs 25%), severe NPDR (19% vs 8%), Proliferative DR (PDR) (18% vs 7%), Advanced Diabetic Eye Disease (ADED) (4.8% vs 1%) and Diabetic Macular Oedema (DME) (62% vs 28%) increased several folds during post lockdown quarter in comparison to prepandemic quarter. There was a statistically significant difference (p-value<0.05) in baseline mean LogMar Best Corrected Visual Acuity (BCVA) (0.4±0.08 vs 0.9±0.07), mean CMT (386.4±26.8 to 421.8±21.6) positive correlations of some of the possible risk factors for poor visual outcome among the same cohort of patients in the post lockdown period: poor socioeconomic status (35%; Odds Ratio (OR):3.59, Relative Risk (RR):2.68), irregular diabetic medication (52%; OR:3.56, RR:2.23), residence more than 100 km from the hospital (38%; OR:3.03, RR:2.26). Conclusion: The present study, concludes that, the status of DR stage among study subjects in the post lockdown period has deteriorated when compared with the prepandemic period.