Tear film profile was studied in 30 patients with Graves' ophthalmopathy. Tear film pH, fluorescein staining, marginal tear strip and Schimer test values in patients with Graves' ophthalmopathy were comparable with controls, indicating normal tear secretion. Tear film break-up-time (BUT) in late Graves' ophthalmopathy was significantly low suggesting unstable tear film. Rose bengal as well as lissamine green staining intensity scores were significantly high, indicating presence of drying epithelial cells in early as well as late Graves' ophthalmopathy patients.
Purpose:
The aim of the study is to identify risk factors, clinical characteristics, causative fungi, and treatment outcome of dematiaceous fungal keratitis in North India.
Methods:
Consecutive cases of culture-proven dematiaceous fungal keratitis between January 2012 and June 2017 were retrieved from the medical record department. Risk factors, clinical signs, and outcome were registered.
Results:
Eighty-three patients were included. Identified dematiaceous fungal organism were
Curvularia
sp. (
n
= 55/83; 66.3%),
Alternaria
sp. (
n
= 12/83; 14.5%),
Ulocladium
sp. (
n
= 5/83; 6%),
Bipolaris
sp. (
n
= 5/83; 6.1%),
Scedosporium
sp. (
n
= 3/83; 3.6%),
Acremonium
sp. (
n
= 2/83; 2.4%), and
Epicoccum
sp. (
n
= 1/83; 1.2%). Male preponderance was reported. The most common predisposing factor was corneal trauma (67.4%). In cases associated with corneal trauma due to vegetative matter, sugarcane was the most common cause. In all, 89% of the patients were more than 30 years of age. The median infiltrate size was 8 mm
2
. The median time of antifungal therapy was 4.2 weeks (interquartile range [IQR]: 1-25 weeks). Complications were seen in 14 (
n
= 14/65; 21.5%) patients. Complete resolution of dematiaceous fungal keratitis was present in 27 (
n
= 27/65; 41.5%) eyes.
Conclusion:
Curvularia
sp. and
Alternaria
sp. were the predominant pathogenic genera causing dematiaceous fungal keratitis. Among the causative fungi, infections due to
Scedosporium
sp. were associated with the worst outcomes.
Ulocladium
sp. and
Epicoccum
sp. were also identified. Both the species are not reported previously as a causal organism of dematiaceous fungal keratitis from North India.
Tear film profile was studied in 100 consecutive patients with dry eye along with 100 age and sex matched controls. The frequency of abnormal tear function tests observed in patients with dry eye and controls was: marginal tear strip 93% and 11%, rose bengal staining 89% and 0%, lissamine green staining 87% and 0%, BUT 79% and 14%, Schirmer test 79% and 3% and fluorescein staining 69% and 0%, respectively. No significant difference was observed between tear pH of patients with dry eye and that of normal healthy subjects. A new, simple and effective objective criteria of confirming and grading dry eye based upon a points scoring system derived from the results of various tear film tests is suggested.
Abstract. The clinical observations made on 20 patients (24 eyes) of Duane's retraction syndrome are presented. A modification of Huber's classification of the syndrome is suggested in order to make it more clinically orientated.
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