Branch Retinal Vein Occlusion (BRVO) is a common retinal vascular disorder which involves one of the branch retinal veins. The aim of the study is to analyse epidemiology, risk factors, clinical characteristics in the distribution of different types of BRVO and final visual outcome after treatment and six months follow up. This is a prospective study including 222 patients of BRVO was done from October-2018 to September-2020. Clinical evalution included, detailed history with systemic risk factors, visual acuity testing, Slit-lamp biomicroscopy, Intra occular pressure, detailed fundus evaluation, fundus fluorescein angiography, Optical Coherence Tomography and Gonioscopy. Laboratory test included complete blood count, Erythrocyte sedimention rate, fasting blood sugar, serum lipid profile. Treatment given, observation and follow up, intravitreal (lV) ranibizumab, IV triamcinolone and laser photo coagulation. Out of 222 BRVO patients, 207 (94.1%) were major BRVO (129(58.1%) were suprotemporal BRVO, 66(29.8%) were inferotemporal BRVO) and 15 (5.9%) were macular BRVO. Maximum number of patients 108 (48.6%) in the age group of 61-70 years. Male patients 126 (56.7%) more than females 96 (43.3%). Right eye 117 cases (52.7%) were involved slight more than the left eye 102 cases (45.9%). Blurring of vision 162 (72.9%) is the commonest symptom. Hypertensive patients 113 (50.9%) affected more followed by Diabetic 36 (16.2%) and cardiovascular disease 33 (14.9%). Mean Systolic blood pressure (SBP), Diastolic blood pressure (DBP), ESR & Fasting blood sugar (FBS) are higher in Macular BRVO, cholesterol level is higher in Major BRVO. Retinal haemorrhage was present in all cases. Macular edema was present in 87.4% of patients in whom OCT was done. At the end of six months after treatment in majority of patients i:e 85.1% had BCVA between 6/6-6/18. There was dramatical improvement of vision after receiving intravitreal Ranibizumab (P value 0.041).There is strong association of conventional risk factors with BRVO. Visual prognosis depends on initial status with careful monitoring for macular ischaemia, macular edema, development of neovascularization and subsequent neovascular glaucoma followed by appropriate therapy like IV Ranibizumab, IV Triamcinolone and laser photocoagulation etc wherever required. There is dramatical improvement of vision after receiving intravitreal Ranibizumab (P value 0.041).

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Purpose: To study the various ocular findings in patients with closed head injuries, to find any association with the degree of neurological involvement, and to analyze the treatment outcome after the necessary intervention.Setting: Tertiary referral hospital in Eastern India.Design: Prospective observational study.Methods: Patients with closed head injuries attending our Outpatient department as well as referred from the Neurosurgery department for ophthalmic evaluation between October 2017 and September 2019 were recruited for the study. All patients meeting the inclusion criteria were examined by an experienced ophthalmologist. The Glasgow coma scale (GCS) was applied to grade the neurological involvement by the neurosurgery team. Ocular findings were recorded and necessary imaging was requested. Appropriate neurosurgery consultations were done in patients with neurological findings. All ocular injuries were managed as per institutional protocol. Descriptive statistics were used for analysis with p< 0.05 taken as statistically significant.Results: A total of 207 patients (414 eyes) were included in the study. The mean age was 33.82 years, with the prevalence of male patients (82.12%). The most common cause of head injury was RTA (57.01%) followed by assault (11.59%). The majority of patients (53.14%) were classified as having moderate, 46.37% patients with mild, and 0.48% with severe neurological involvement as per GCS scoring. Isolated ocular findings were seen in 70.04% of patients while 29.95% of patients had both neurological and ophthalmic features. Ocular adnexal involvement was observed in 38.6%, anterior segment involvement in 86%, neuro-ophthalmic manifestations in 33.3%, and posterior segment involvement in 38.6% of patients. Ocular signs were resolved over due course of time in 48.8% of patients, completely resolved in 28%, while there was no improvement in 6.28% of patients. The final best-corrected visual acuity of >6/18 was achieved in 51.69% of patients. Statistical significance was observed in the correlation between the GCS scoring and general ocular findings (p= 0.02) as well as a relative afferent pupillary defect (p=0.003). The association between age > 50 years and neuro-ophthalmic features was not found to be statistically significant (p=0.56). Conclusion:Poor visual acuity at presentation, optic canal fractures, the presence of multiple fractures of orbital walls, no improvement in vision within 48 hours of starting intravenous corticosteroids, were indicators of a poor visual prognosis in this study. The GCS, neuro-deficit, and ocular signs contribute significantly to the prediction of outcomes. Prompt treatment and referral can lead to a good resolution of symptoms and signs.

The Primary open-angle glaucoma is the most common type of glaucoma causing irreversible blindness. Myopia is one of the risk factor responsible for pathogenesis of glaucoma. The association between myopia and primary open angle glaucoma has been found in numerous case studies. The aim of the study to evaluate the relationship of myopia in primary open-angle glaucoma by classifying the eyes into low, moderate and high myopia.This prospective study was performed on 1414 axial myopic patients more &#62; 18 years. Clinical examination included, slit-lamp biomicriscopy, Goldman applanation tonometry, refraction, dilated optic disc assessment, central corneal thickness, visual field analysis and optical coherence tonography.Out of 1414 patients, 769(54.38%) were male and 645(45.62%) were female. Low myopia (&#60;-3D) cases are 938(66.32%), moderate myopia (-3D to -D) 309(21.88%), high myopia (&#62;-6D), 107(11.8%). Maximum number of cases were in younger age group (20-30 years). Intraoccular Pressure &#62; 21mmHg in 143 cases of low myopia, 78 cases in moderate myopia, 72 cases in high myopia. There were 138 cases with glaucomatous field changes. Out of 138 cases 86(62.32%) were high myopia, 35(25.36%) were moderate myopia and 17(10.8%) cases were low myopia. The CUP-DISC ratio &#60;0.5 in 75.95% cases, 0.5-&#60;0.9 in 20.37% cases, &#62;0.9 in 3.68% cases. The average values of circumpapilary Nerve Fiber Layer thickness in micrometer of low myopia, moderate myopia, high myopia, with non-glaucomatous cases were 98.9, 97.3, 93.5 and with glaucomatous cases, 74.4, 73.7 and 73.3 respectively. The average values of Ganglion Cell Complex thickness in micrometer in low, moderate and high myopia without glaucoma were 94.9, 93.5, 92.7 and with glaucoma 77.3, 74.6, 70.2 respectively. This study shows there is strong relationship between myopia and primary open-angle glaucoma. Early detection of glaucoma in myopic patients is necessary in delaying blindness.