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The use of small-gauge trocar cannulas during transconjunctival sutureless pars plana vitrectomy (PPV) facilitates the smooth transition of instruments into the posterior segment and reduces trauma. However, room lighting is routinely dimmed during PPV, thereby making cannula visualization difficult and hence compromising efficient instrument exchange. We report the use of a frugal, fluorescent "glow-in-the-dark" ring placed over vitrectomy cannulas to visualize the cannula entry, thereby providing a smooth and efficient instrument exchange. We 3D-printed phosphorescent rings of optimum inner diameter to comfortably fit around the trocar cannula (The Glowport). Two such rings are fitted into the two trocar cannulas prior to surgery initiation. The cannulas are then passed via sclerostomy as performed in routine PPV. The light from the fiberoptic endo-illuminator is focused over the rings for approximately 5 seconds to activate the photoluminescence. Under mesopic conditions, the fluorescence provides visualization of the cannula entry and helps in the facilitation of smooth entry and exchange of instruments into the globe for performing vitreoretinal surgical procedures, which helps in reducing ocular touch errors as well as surgical time. The Glowport is a frugal device retrofitted onto the trocar cannulas and helps in the smooth entry and exchange of instruments under darkroom conditions, which are required in vitreoretinal surgery., (Copyright © 2024 Indian Journal of Ophthalmology.)

Background: Finding a retinal break which is responsible for retinal detachment is a critical step in the surgical treatment of this condition. In spite of improvement in visualization systems in pars plana vitrectomy, identifying the break which is the source of subretinal fluid (SRF) could pose a challenge, especially in complex retinal detachments or re-detachments with extensive laser scars., Purpose: The current technique of break identification involves direct detection of the break via peripheral indentation or using perfluorocarbon liquid (PFCL) to displace SRF from the posterior retina to the periphery and visualizing the proteinaceous SRF egress from the retinal break. In retinal detachments, if no peripheral breaks are visualized, surgeons tend to make a posterior draining retinotomy and drain SRF, the necessity of which can be confirmed after subretinal brilliant blue green (BBG) dye injection. In addition, in already vitrectomized eyes where it can be difficult to identify SRF egressing via the break, subretinal BBG dye provides a color contrast that enhances break visualization., Synopsis: A method to identify these occult breaks was required, which is described in this video. Hence, the idea of BBG dye injection into the subretinal space with a 41G subretinal needle was thought of. PFCL would be placed over the posterior pole, which would displace the dye to the periphery, and this would disperse out into the vitreous cavity into a blue plume via the break, thereby leading to its identification., Highlights: Subretinal dye injection is useful for occult retinal break detection as it provides a color contrast. A posterior draining retinotomy can be avoided. It is also useful in recurrent retinal detachments. We describe the use of BBG, which is the least toxic dye available, and report the use of this technique in Indian eyes., Video Link: https://youtu.be/JGXQjNV9asw., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

In this report, we have utilized a smartphone-based innovative tool named anterior segment photography with an intraocular lens (ASPI) with a cobalt blue filter on the smartphone flash for photographing fluorescein-stained corneas. An intraocular lens along with a cobalt blue filter was attached to the smartphone camera to achieve this purpose. The filter could block out all wavelengths of light except the blue wavelength (450-490 nm) emerging from the smartphone camera. A pilot study was conducted on 27 eyes of 25 patients where images of various corneal pathologies were obtained using ASPI blue light imaging. The images were clear and highly magnified and could be used for documentation, teleconsultation for expert opinion, education, and monitoring of disease progression. ASPI-aided blue light imaging could be easily fabricated and is a frugal inexpensive device, which is used by different ophthalmic personnel to obtain fluorescein-stained corneal images.

The authors describe a novel technique of performing retinoscopy assisted with a smartphone (gimbalscope). We found this technique of digital retinoscopy to be useful for demonstrating and documenting retinoscopic reflexes and in addition as an easy teaching tool. This technical report explains the assembly of our smartphone-assisted retinoscope and provides examples of the range of normal and abnormal reflexes that can be captured., Competing Interests: None

This case series describes the ocular and retinal manifestations of rare eye diseases in systemic syndromes. This observational case series consists of five patients with varied ophthalmic manifestations and documentation of imaging in rare pediatric and adult retinopathies. Two patients had Kearns Sayre syndrome (KSS) based on the classical triad of external ophthalmoplegia, pigmentary retinopathy, and onset before 20 years of age. In one patient of KSS, the mitochondrial retinopathy was seen in an asymmetric pattern, and the second patient presented with KSS after being mis-diagnosed as myasthenia gravis elsewhere. A case of Senior Loken syndrome in pediatric age is described in this series with varied ophthalmic manifestations ranging from retinitis pigmentosa to orbital abscess. This series also enlightens features of Hallervorden Spatz syndrome presenting with bull's eye maculopathy and a case of spino-cerebellar ataxia type 7 presenting with pigmentary retinopathy., Competing Interests: None

The emergence of smartphone-based imaging devices has been a boon in the field of ophthalmology, especially in obtaining high-quality ocular images. They can be specialized and utilized for imaging-specific regions of the eye. Among the multitude of applications of smartphone-based imaging, one of the upcoming major use is to image the microbiological world. Previous few reports have described attaching magnifying lenses of various types to the smartphone camera and transforming it into a microscope for imaging fungal hyphae and ocular surface parasites. We describe a novel technique of attaching the smartphone-based intraocular lens microscope (IOLSCOPE) to the slit lamp, thereby utilizing the slit lamp joystick for moving the smartphone over the concerned slide specimen to make it steady and obtain images of high resolution. This innovative do-it-yourself novel modification is especially useful in peripheral centers, vision centers, and local clinics for immediate screening and identification of microbial pathogens such as fungi and ocular surface parasites., Competing Interests: None

Purpose: To assess the retinal manifestations of Parkinson's disease using optical coherence tomography., Methods: A prospective case-control study comparing 30 eyes from 15 patients with Parkinson's disease and 22 eyes from 11 healthy age-matched controls. Total macular subfield thickness and the thickness of the ganglion cell layer, nerve fiber layer, and peripapillary retinal nerve fiber layer were measured with spectral-domain optical coherence tomography (SD-OCT)., Results: The mean age of PD patients was 68.4 years ± 10.64 (range: 46-82) and in the control group was 66.36 ± 5.22 (range: 64-68). The average disease duration in patients with PD was 6.7 ± 2.8 years (range: 2-10 years). The mean best-corrected visual acuity in PD was 20/26 and 20/20 in controls, with P = 0.0059, which was significant. Significant difference was also found in the contrast sensitivity between both groups. Structural differences in the central macular thickness (P = 0.0001), subfield thicknesses in the superior (P = 0.003), inferior (P = 0.001), nasal (P = 0.004), and temporal subfields (P = 0.017) was seen. Severe thinning of the ganglion cell layer was seen in PD patients (P = 0.000) as well as of the nerve fiber layer (P = 0.004). Peripapillary retinal nerve fiber thickness measured showed significant thinning in superotemporal (P = 0.000), superonasal (P = 0.04), inferonasal (P = 0.000), inferotemporal (P = 0.000), nasal (P = 0.000), and temporal quadrants (P = 0.000)., Conclusion: Visual dysfunction was observed in patients with PD along with structural alterations on OCT, which included macular volumes, ganglion cell layer, and peripapillary retinal nerve fiber layer., Competing Interests: None

Competing Interests: None

We present a case of large peripapillary polypoidal choroidal vasculopathy treated with standard-fluence photodynamic therapy (PDT) as other treatment options were unsuccessful or not justified. Due to large lesion size, treatment spot included part of optic disc also. PDT resulted in regression of polyp and visual improvement (from 20/300 to 20/20) without any collateral damage to optic nerve as evidenced by visual-field test and visual-evoked potential with a follow-up till 2 years. This case highlights the role of PDT as a safe alternative for treatment of large peripapillary lesion, even though the treatment spot encompasses part of the optic nerve head., Competing Interests: None