Objective: To determine the reliability and validity of the flashlight test and van Herick's test in detecting occludable anterior chamber angles.Methods:The flashlight test, van Herick's test and gonioscopy were performed independently by two observers on 96 consecutive new patients in our outpatient clinic. lnterobserver agreement was determined using the weighted Kappa statistic. Using the glaucoma specialist's assessment of occludability of the angle (assessed by gonioscopy) as a gold standard, the sensitivities and specificities of the two tests were calculated.Results: All three tests showed good agreement (Kappa more than 0.75). The sensitivity and specificity of the flashlight test were 45.5% and 82.7% respectively. For the van Herick's test they were 61.9% and 89.3%. Conclusion:The flashlight test and van Herick's test are of limited use as screening tests for occludable angles.

No abstract

A larger number of normal eyes obeyed the IST rule compared with the ISNT rule for the RNFL thickness measured by HRT and OCT. Exclusion of the nasal sector from the analysis (IST rule) marginally improved the specificity in diagnosing glaucoma at the cost of the sensitivity, making neither of these parameters (ISNT and IST) likely to be useful clinically.

No abstract

Purpose:The purpose was to study the dimensions of the foveal avascular zone (FAZ) using Heidelberg Retinal Angiogram-2 (HRA-2; Heidelberg Engineering GmBH, Dossenheim, Germany).Materials and Methods:An observational study of the FAZ area and circumference was done with fundus fluorescein angiography (FFA) using HRA-2 in 31 normal individuals. The FAZ was studied using both contrast-adjusted and nonadjusted methods. Contrast adjustment was done to obtain better visualization of the finer capillaries around the fovea enabling more precise measurements of the FAZ in normal eyes.Results:The mean area of the FAZ calculated by the contrast-adjusted method was 0.2753 mm2 (±0.074) and the mean circumference was 2.22 mm (±0.048). By the conventional method, the area and circumference of the FAZ were 0.6241 mm2 (±0.177) and 3.23 mm (±0.454), respectively.Conclusion:The measurements of area and circumference of FAZ using contrast-adjusted methods were significantly smaller than the conventional method.

A 32-year-old woman presented with mild enophthalmos of her right eye of recent onset. A CT scan revealed characteristic findings of silent sinus syndrome, involving not just the maxillary but the less frequently reported ethmoid sinus as well. A clinically and radiologically noted shrunken and lateralized middle turbinate was a strong pointer to the suspected cause. The symptoms resolved with endoscopic sinus drainage.

Purpose:To study the clinical profile of pseudoexfoliation (PEX) syndrome in a hospital setting.Materials and Methods:A case series of patients with PEX, with and without glaucoma attending the general ophthalmology clinic of a tertiary care center in South India. All patients underwent a complete ophthalmologic evaluation including recording diurnal variation of tension (DVT), gonioscopy and visual field assessment.Results:The study cohort comprised 529 patients (752 eyes). There were 296 (56%) females. The highest number of patients (261 patients) was from the age group between 60 and 69 years. Of 752 eyes, 57.8% eyes had unilateral PEX and 72% had established PEX. Gonioscopy showed open angles in 98.1% of eyes. Intraocular pressure (IOP) greater than 21 mmHg in at least 1 of 4 measurements was recorded in 5.7% eyes. DVT was normal in 96.4% of unilateral PEX eyes, similar to fellow non-PEX eyes. Pseudoexfoliation glaucoma occurred in 1.9% of eyes and 4.7% of eyes were glaucoma suspects. There was no correlation between the stage of PEX and increased IOP. Mean central corneal thickness of PEX eyes was 522 ± 27μ. Pupillary dilatation in 90.5% eyes with early PEX was ≥ 7 mm.Conclusions:A small percentage of PEX eyes had raised IOP, and the number of eyes with glaucomatous optic neuropathy was even lower. PEX eyes did not demonstrate wide fluctuations in IOP. No correlation was found between raised IOP and stage of PEX. There was good pupillary dilatation in early stage PEX eyes suggesting that all PEX eyes may not have poor pupillary dilatation and related complications.

We report a case series of endophthalmitis by an organism hitherto not reported in the eye. Nineteen of 63 cataract patients operated in a high-volume setup were urgently referred to us with acute onset of decreased vision one to two days following cataract surgery. All patients had clinical evidence of acute endophthalmitis with severe anterior chamber exudative reaction. Vitreous tap was done in three representative patients and repeated intravitreal injections were given as per established protocol. The vitreous sample from all three patients grew Enterobacter amnigenus Biogroup II, a gram-negative bacillus which, to the best of our knowledge, has never been reported in the eye. With prompt and accurate microbiological support, it was possible to salvage 17 of these eyes without performing vitrectomy. Six eyes regained 6/200 or better vision.