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Introduction: Glaucoma is one of the leading cause of irreversible blindness worldwide. Among the affected ones, approximately 50% are not aware of it, because of its asymptomatic nature, especially in the early stages. Ripasudil Hydrochloride Hydrate is a novel drug, being the Rho-associated coiled-coil- containing protein kinase (ROCK) inhibitor eye drop that increases conventional aqueous outflow through the trabecular meshwork and Schlemm’s canal and thus lowers the intraocular pressure. Material and Methods: This prospective study included the first 150 consecutive eyes in patients of uncontrolled glaucoma with IOP > 21 mmHg despite maximal topical anti-glaucoma medications in at least one eye and aged eighteen or above. The patients with neovascular glaucoma, closed or barely open anterior chamber angle or with history of ocular surgery including refractive surgery were excluded. The purpose and nature of the study were explained in detail, and informed consent was obtained from all patients. Results: This study included 115 patients with 150 affected eyes. The mean age of patients in this series was 43.6 years with a range of 24-73 years. Right eye was affected in 47, left in 33 patients and the remaining 35 patients had bilateral involvement. The mean pachymetry was 521.13 μm in right eye and 523.53 μm in left eye and the mean cup disc ratio was 0.8 and 0.7 in right and left eye respectively. The mean baseline intraocular pressure in our series was 18.60 mmHg +- 7.60 mmHg. The mean IOP at six month follow up visit (final follow-up) was 11.83mmHg +- 4.45, which was statistically significant. The mean reductions in IOP at one month was 12.64mmHg, at 3 months follow up 12.07mmHg. Conclusion: The results of our study implies that ripasudil is a favourable anti glaucoma drug that can lower intraocular pressure. The additive pressure lowering effects of ripasudil in addition to existing maximal therapy can be because of different mechanism of action, it can delay or evade surgery in glaucoma. Transient conjunctival hyperaemia, not necessitating discontinuation was the most common complication in this series. [ABSTRACT FROM AUTHOR]

Background: Dry eye disease is a multifactorial disease with varying presentations ranging from minor discomfort to sight threatening complications. Different drugs are used to treat dry eye and act on different layers of the tear film. Rebamipide is a new emerging drug that specifically addresses mucin deficient dry eye. Purpose: To evaluate the efficacy of 2% rebamipide and to compare it with 0.1% sodium hyaluronate in the treatment of dry eye disease. Material and Methods: 130 patients visiting the eye OPD of a tertiary care hospital in North India with dry eye disease were enrolled and divided randomly into two groups of 65 patients each. One group was prescribed 2% rebamipide eye drops 4 times a day and the other was prescribed 0.1% sodium hyaluronate 6 times a day for 6 weeks. Schirmer's test values, tear film breakup time (TBUT), Lissamine green staining score and a dry eye related questionnaire were evaluated at 2, 4 and 6 weeks. Results: The difference between the results of the two groups was found to be statistically significant (p value <0.05) at 6 weeks of therapy. Conclusion: Rebamipide proved to be better than sodium hyaluronate in reducing the symptoms and improving clinical signs like Schirmer's values, TBUT and lissamine staining score when used for up to 6 weeks and may emerge as 1st line treatment for dry eye disease in near future. [ABSTRACT FROM AUTHOR]

Background: Traditional method of learning via face to face lecture has been in curriculum since times immemorial. E-learning via multimedia has been a recent introduction in education system. Purpose: To compare e-learning with the traditional method of teaching in medical education. Material and Methods: The two different methods of teaching were applied on the same group of students. A total of six lectures were conducted. Three of them were taught by traditional method of teaching and three by e-leaning. Formative assessment in the form of written examination was carried out, followed by qualitative assessment at the end of session. Results: The mean marks obtained after Exam-1 (i.e. following traditional teaching method) was 6.46 ± 1.48 and mean marks obtained after Exam-2 (i.e. following e-learning) was 8.37 ± 1.27. The mean difference score was 1.91 ± 1.55. The paired t-test was applied, and the value of t was 11.96 with p-value <0.001. The results between two teaching methods were statistically significant. For qualitative analysis Likert scale was used. 66% of students strongly agreed that e-learning is a superior method than traditional method of learning. Conclusion: The e-learning proved to be more efficient and uniform method of student learning with revision facilities. [ABSTRACT FROM AUTHOR]

Glaucoma is the leading cause of irreversible blindness worldwide. Primary Open Angle Glaucoma (POAG) is usually asymptomatic till advanced stages of the disease. Intraocular pressure (IOP) is the primary risk factor for development of POAG. But in spite of control of IOP, some cases progress which strengthens the view that there must be other independent risk factors in the pathogenesis of glaucoma. Serum lipids have been found to be associated with glaucoma in few studies. We conducted a study to assess the relation between dyslipidemia and glaucoma on 100 cases of glaucoma and 100 age-matched controls. Detailed ophthalmic examination was done in all subjects and fasting lipid profile was compared between cases and controls. Levels of total cholesterol, total triglycerides and LDL were significantly higher in cases than in controls with a p value < 0.0001. We conclude that dyslipidemia is an independent risk factor for POAG. [ABSTRACT FROM AUTHOR]

A prospective study was conducted in upgraded department of ophthalmology Government Medical College Jammu. The aim was to evaluate the surgically induced astigmatism (SIA) by 2.8 mm superior clear corneal incision after phacoemulsification. Fifty eyes of exact number of patients were included in the study. The average age and preoperative astigmatism was computed. All patients were treated with 2.8 mm clear corneal superior approach phacoemulsification. Patients received detailed ophthalmological investigations in addition to keratometry both pre- and post-operatively. SIA was calculated by using SIA Calculator Version 2.1. Age wise the cataract patients were in all four age groups of 41-50 years (15/ 30%), 51-60 years (14/ 28%), 61-70 years (18/ 36%) and 71-80 years (3/ 6%). The mean age of cataract patients was 56.8 ± 9.31 years. The preoperative astigmatism under study patients ranged from 0 D to 2.25 D. 80% of the cataract patients had preoperative astigmatism to the levels of 1.0 D and 20% patients 1.25 D and above. On all intervals of study period the SIA range was up to 3.0 D. Postoperatively from day- 1 to week- 6 intervals, SIA not only decreased but also shifted to lower range. Final mean values of SIA were 1.565 ± 0.555 D, 1.425 ± 0.690 D, 1.02 ± 0.686 D, and 0.66 ± 0.67 D on day- 1, week -1, -4 and -6 respectively. The uncorrected visual acuity was 6/36 to 6/18 in 10 (20%) patients and 6/12 to 6/6 in 40 (80%). The best corrected visual acuity was 6/36 to 6/18 in 8 (16%) patients and 6/12 to 6/6 in 42 (84%) patients. [ABSTRACT FROM AUTHOR]

A cross-sectional study was done on a total of 158 known cases of type II diabetes mellitus, with no history of ocular treatment to investigate the role of various risk factors associated with diabetic retinopathy. The patients were screened for presence or absence of retinopathy on the basis of dilated fundus examination. The patients showing retinopathy were graded for the type of retinopathy on the basis of Early Treatment Diabetic Retinopathy Study (ETDRS) classification system. The patients were divided into 2 groups: Group A composed of diabetic patients with no retinopathy and Group B comprised of diabetics with retinopathy. A detailed history was taken; physical examination and laboratory investigations were done in each case. Out of 158 patients with diabetes, 75(47.47%) had diabetic retinopathy. 23 patients (14.56%) had mild non-proliferative diabetic retinopathy (NPDR), 22(13.92%) moderate NPDR, 18(11.39%) severe to very severe NPDR and 12(7.59%) had proliferative diabetic retinopathy (PDR). The risk factors found to be significant for presence of retinopathy on univariate analysis were duration of diabetes (p<0.0001), glycated haemoglobin (HbA1c) (p<0.0001), proteinuria (p<0.0001), serum creatinine (p<0.0001), associated hypertension (p=0.001), hypomagnesaemia (p= 0.0004) and insulin use (p= 0.009). On multivariate analysis, only duration of diabetes (p=0.000), proteinuria (p=0.022) and hypomagnesaemia (p=0.015) were found to be significant. This study concludes that duration of diabetes, proteinuria and hypomagnesaemia are significantly associated with the risk of developing diabetic retinopathy. [ABSTRACT FROM AUTHOR]

A prospective interventional self-control study to analyse the profile and outcome of suture less and glue free limbal conjunctival autograft for the management of primary pterygium was carried out in 80 eyes with primary nasal pterygium requiring surgical excision. Pterygium excision with limbal conjunctival autografting without using glue or sutures was performed in all the eyes followed by bandaging for 24 hours. The patients were followed up post operatively after 24 hrs., on 3rd day, after 1, 3, 6 weeks and at 3 months. They were examined for visual acuity, hemorrhage, wound gape, graft retraction, graft edema, recurrence or any other complication among the study population. The mean age of the patients was 40.78 years (range 19-80), 56.25% of which were females. Graft retraction occurred in 3 eyes (3.75%) and recurrence was seen in 1 eye (1.25%). Hemorrhage was seen in 26 (32.5%) eyes at 24 hours, which persisted in only 06(7.5%) eyes at 3 weeks and resolved completely in 100% of eyes at 6 weeks. Edema was also noted in 4 (5%) eyes, persisted only in 1(1.25%) eye at 3rd day and resolved completely by 1 week. At 6 weeks postoperatively, three (3.75%) eyes showed gain in best corrected visual acuity by one line and one (1.25%) eye by three lines on snellen's drum. No other complication was noted. Suture less and glue free limbal conjunctival autografting following pterygium excision is an effective and safe option for the management of primary pterygium. [ABSTRACT FROM AUTHOR]

The current study was done to evaluate the utility and safety of Trypan Blue staining of the anterior capsule for enhancing visualization of capsulorrhexis in mature and hypermature cataracts.This study included 100 eyes of 100 patients with a unilateral mature or hypermature cataract. In all these cases 0.2ml of 0.1% Trypan blue dye was used to stain the anterior capsule in cataract surgery. In all 100 eyes the Continuous Curvilinear Capsulorrhexis (CCC) was completed. Successful cataract surgery with intraocular lens (IOL) implantation was performed in all eyes. Adverse reactions related to the dye such as raised intraocular pressure or anterior chamber inflammation was not observed in the immediate postoperative period or at the end of mean follow-up of 3 months. Trypan blue dye staining of the anterior capsule was found to be an effective and safe technique that helps in completion of Continuous Curvilinear Capsulorrhexis (CCC) in mature and hypermature cataracts. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus has toxic effects on all cells of the body. Cornea is no exception and structural and morphological alterations have been found in endothelial cells in diabetics. Purpose: To evaluate and compare central corneal thickness, and endothelial cell count and morphological characteristics between diabetics and non-diabetics and to determine the relation of these parameters with the diabetes duration. Material and Methods: This hospital based analytical observational study included 65 type II diabetics with good glycaemic control and 65 age-matched non-diabetics as control. The diabetics were further divided on the basis of duration of diabetes into two groups: -10 years and >10 years. The study parameters included central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variation (CV) and percentage of hexagonal cells (% HEX) using Topcon specular microscope by the same observer. Results: Mean CCT was observed to be significantly greater in diabetic eyes (516.51 ± 20.83 µm) than in control group (507.42 ± 28.41 µm) (p=0.0391). Mean CV was higher in endothelial cells of diabetic corneas (34.20 ± 4.15) than non-diabetic corneas (32.89 ± 2.98) (p=0.041). The diabetic group had lower mean ECD and percentage of hexagonal cells than the control group, without any statistical significance (p=0.092 & p=0.085, respectively). Of 65 patients with diabetes, 29 were with duration of DM -10 years and 36 with duration of DM >10 years. No statistically significant difference was noticed on comparing the corneal parameters among these two diabetic groups. Also, no significant correlation was observed between these endothelial parameters and duration of diabetes. Conclusion: Diabetics have thicker corneas and increased polymegathism of endothelial cells in comparison to age-matched non diabetics, whereas density and hexagonality of endothelial cells was found to be similar between the two groups. The effect of diabetes duration on these endothelial parameters is insignificant in this study. [ABSTRACT FROM AUTHOR]

The article discusses the peripheral eye camps in India which has been widely used for several reasons like the willingness of patients to seek treatment when they are part of a group. It notes the two types of eye camps that are both community-orientated approaches designed to tackle cataract blindness under the government's National Programme for the Control of Blindness. Other topics include quality of eye surgery, total expenditure on drugs and consumables and cataract surgery costs.

Background: Retinopathy of prematurity (ROP) is a vascular disease of retina seen in premature infants which is associated with various risk factors. Objective: To find out the risk factors associated with ROP in tertiary eye care center. Material and Methods: The study was a hospital based, cross-sectional, observational study involving babies at risk of retinopathy of prematurity (ROP). A total of 400 infants were screened using indirect ophthalmoscope. At the time of screening the factors which were studied includes sex, gestational age, birth weight, respiratory distress syndrome, sepsis, blood transfusion, apnea, phototherapy and intraventricular hemorrhage. Results: Out of 400 neonates, 232 (58%) were males and 168 (42%) were females. ROP was seen in 70 (17.5%) of these 400 neonates. Of these 70 neonates, 42.8% developed stage-1 ROP, 45.7% developed stage-2 ROP, 5.71% developed stage-3 and 5.71% developed stage-4. Gestation age ≤34 week (p= 0.008) and birth weight <2kg (p<0.001) were found to be significant risk factors for ROP development. Respiratory distress syndrome (p=0.012) and oxygen supplementation(p<0.001) are also significant risk factors for the development of ROP. Conclusion: This study shows low birth weight, low gestation age, Oxygen supplementation and respiratory distress syndrome are associated with development of ROP. Such analysis of risk factors helps us to predict ROP in high-risk cases. [ABSTRACT FROM AUTHOR]

Background: Pseudoexfoliation causes characteristic corneal endothelial changes leading to corneal decompensation and loss of corneal transparency severely affecting vision. Objectives: To evaluate morphological changes in corneal endothelial cells and central corneal thickness in pseudoexfoliation syndrome (PXS) and to compare it with age matched patients without pseudoexfoliation syndrome. Material and Methods: A hospital based, cross sectional analytical study was conducted at Upgraded Department of Ophthalmology, Government Medical College/hospital, Jammu in which total of 46 patients planned for cataract surgery were included (23 patients with pseudoexfoliation syndrome and 23 patients without pseudoexfoliation syndrome). Corneal endothelial cell density (ECD), percentage of hexagonal cells, coefficient of variation (CV) in cell size, and central corneal thickness (CCT) were measured using specular microscopy. Results: The mean ECD was 2325.1 ± 383.1 in the PXS group and 2763 ± 351.3 in the control group respectively, and ECD in the PXS group was significantly lower than in that in the control group (p=0.0002). The percentage of hexagonal cells was 48.3 ± 5.7 in PXS group and 51.5 ± 4.6 in the control group respectively, and percentage of hexagonal cells was significantly lower than that in the control group (p=0.04). The cell size coefficient of variation was 33.9 ± 2.6 in the PXS group and 33.0 ± 3.1 in the control group respectively, and patients with PXS had no statistically significant difference in cell size coefficient of variation compared to control group (p=0.29). The CCT was 509.0 ± 27.3 in the PXS group and 529.0 ± 23.6 in the control group respectively, and CCT in the PXS group was significantly lower than that in the control group (p=0.01). Conclusion: In our study the ECD and CCT was significantly lower in patients with pseudoexfoliation syndrome regardless of the presence of pseudoexfoliative glaucoma. [ABSTRACT FROM AUTHOR]