BACKGROUNDNasolacrimal duct obstruction will lead onto dacryocystitis. This may occur in neonates and children and also. In adults it usually has a chronic course which may end in procedures like Dacryocystorhinostomy (DCR). These procedures have significant failure rate.

BACKGROUND Central retinal artery occlusion (CRAO) was first described by Van Graefe in 1859 as an embolic event to the central retinal artery in a patient with endocarditis. CRAO has various causes, but patients typically present with sudden, severe, and painless loss of vision. Retinal arterial occlusions are a cause for profound visual loss in the population. Carotid atherosclerosis is common in elderly people. Dyslipidaemia, hypertension, and diabetes mellitus are factors which accelerate the development of carotid atheromatous plaques. Embolism from the carotid bifurcation is the most common cause of retinal artery occlusions. In retinal arterial occlusion carotid arterial occlusion is usually assessed using radiological techniques. The purpose of this study was to evaluate carotid atherosclerotic disease in patients with arterial occlusions in the eye and determine the relation between arterial occlusions in the eye & carotid artery occlusive disease. METHODS This retrospective study included patients aged thirty and above, who had come with symptoms suggestive of arterial occlusions in the eye and carotid doppler was done. The inclusion criteria included patients diagnosed with the following conditions CRAO, branch retinal artery occlusion (BRAO), ophthalmic artery occlusion, anterior ischaemic optic neuropathy (AION) and cilioretinal artery occlusion. Patients usually present with sudden loss of vision in one eye. After taking a detailed history, all patients were subjected to a thorough ocular examination. Patient’s vision is assessed using Snellen’s visual acuity chart, pupillary assessment done, and fundus examination to look for retinal arterial occlusion is also done. Fundus imaging is also done. Carotid doppler was done to rule out carotid artery occlusive disease. RESULTS Patients presenting with retinal arterial occlusion should be investigated thoroughly for both systemic and local causes of CRAO. The risk of developing arterial occlusions were 1.7 - 9.15 times more in patients with carotid artery occlusion than in patients with normal carotids. Arterial occlusion was more found in patients with 70 % occlusion of the carotid artery. CONCLUSIONS There was a strong association between retinal arterial occlusions and carotid artery occlusion. KEYWORDS Central Retinal Artery Occlusion (CRAO), Carotid Artery Occlusive Disease, Carotid Doppler

BACKGROUND CSC is characterised by a serous detachment involving the fovea. CSC may make the patient hypermetropic. It is primarily a disease of the choroid as evidenced by the fact that the asymptomatic other eye of patients with CSC shows thick choroid. Symptomatic eye with CSC very often shows pigment epithelial detachments. Pigment epithelial detachments have also been noted in the asymptomatic other eye of patients with CSC. MATERIALS AND METHODS Spectral Domain (SD), Optical Coherence Tomography (OCT) provides high resolution images of the retinal layers and improved visualisation of the choroid. This study was done to assess the SD-OCT changes in asymptomatic eye in patients with unilateral CSC. RESULTS 19 cases (53%) had SD-OCT changes in asymptomatic eye. Out of this, 13 (37%) cases had PED, 5 (13%) cases with subretinal fluid (13%) and 6 (16%) cases had retinal pigment epithelial changes.

BACKGROUNDPanretinal photocoagulation (PRP) is done for severe nonproliferative diabetic retinopathy (NPDR) or early proliferative diabetic retinopathy (PDR). When it is done for patients without macular oedema PDR may induce a macular oedema which may worsen the visual acuity. MATERIALS AND METHODSA prospective cohort study was conducted for one year with minimum follow up period of 6 months .Seventy eyes of 41 patients who were undergoing PRP for severe nonproliferative diabetic retinopathy or early proliferative diabetic retinopathy were studied. These eyes had best corrected visual acuity (BCVA) ≥0.6 and no macular oedema as determined by clinical examination using 78 diopter lens and Optical Coherence Tomography (OCT)) (Zeiss Cirrus HD OCT). The BCVA was determined using decimal charts and converted into logarithm of minimal angle of resolution scale for statistical analysis. Visual acuity and macular thickness at 1, 3, 6 and 12 months post PRP were studied. RESULTSThe Central Macular Thickness (CMT) measurements (mean±standard deviation)were 160±15 before PRP and 176±16,178±20,189±30,187±25µm at 1,3,6 and 12 months after PRP respectively (P <0.05 for each). The mean±standard deviation of the visual acuity measurements converted into logarithm of the minimal angle of resolution was 0.03±0.12 before PRP and 0.04±0.13, 0.04± 0.12, 0.03±0.08, 0.03±0.08 at 1,3,6 and 12 months after PRP. There was no statistically significant difference in visual acuity in follow up examinations from the pre PRP levels (P>0.05 for each). CONCLUSIONRoutine PRP with 2000 burns given in two divided sessions at two weekly intervals can safely be performed with no effect on visual acuity in patients with severe DR without pre-existing macular oedema.