Purpose: To study the demographic profile and visual outcome in pediatric ocular trauma. Study Design: Prospective and interventional study. Setting: Tertiary eye care center in central Maharashtra. Materials and Methods: The study included all children of age group 15 years and younger sustaining eye injuries and presented to the outpatient department or emergency services. The duration of the study was 1 year. A detailed medical history was obtained. Demographic profile was noted. A detailed ocular examination included visual acuity, slit-lamp biomicroscopy, and fundus examination. All patients were followed up to 6 months. Results: Out of 350 children examined, 66 (18.9%) had ocular trauma. The mean age at presentation was 8.33 ± 4.03 years. Children aged 6-10 years (39.3%) were most commonly affected followed by children from 11 to 15 years (36.1%). There were no significant differences between rural (54.1%) and urban (45.9%) children. Most (63.9%) had open and 24.6% had closed globe injuries. Perforating injuries to the cornea (n=29, 47.5%) was the most common injury. Sports-related injuries were common (n= 18) followed by wooden stick-(n = 14) and firecracker-related (n = 11) injuries. In the open and closed globe injuries, 36 (92.3%) and 5 (33.3%) patients, respectively, required immediate surgical intervention. Conclusion: Sports-related activities were a common cause of ocular trauma in the pediatric age group in the central region of Maharashtra. We propose setting of rapid action ocular trauma team to prevent blindness occurring due to trauma.

BACKGROUNDDiabetic retinopathy is most common ocular complication of diabetes mellitus. Retinal neovascularisation is important cause of vision loss in diabetic patients. Panretinal photocoagulation has been standard treatment for proliferative diabetic retinopathy for several decades. However, intravitreal anti-VEGF now becoming popular in treatment of proliferative diabetic retinopathy and macular oedema.The aim of the study is to compare the effects of Panretinal Photocoagulation (PRP) with PRP plus intravitreal injection of ranibizumab in patients with high-risk Proliferative Diabetic Retinopathy (PDR).

Introduction: Corneal buttons removed during penetrating keratoplasties (PK) from recipients' which were routinely discarded were studied with aim to analyze the common indications of PK and changing pattern of corneal diseases in developing countries like India. Materials and Methods: This is an observational case series carried out in tertiary care hospital of central India from October 2012 to October 2014. Histopathology of 156 corneal tissues was done of which 75 were recipients' corneal tissues removed during PK and 81 were residual adjacent donors' corneal tissues left out after corneal button was removed for transplant. Results: The most common indication of PK in our study was corneal ulcer (n=37, 49.33%), followed by infectious keratitis (n=22, 29.33%) which included ulcers in various stages of healing and complications associated with ulcer like adherent leucoma. Amongst infectious keratitis, 17 were (77.27%) of bacterial keratitis and 5 (22.73%) of fungal keratitis. Followed by bullous keratopathy 8(10.66%), 3(4%) of graft rejection and one each (1.33%) of Fuchs' dystrophy and chronic actinic keratopathy. Of 81 donor's corneal tissues, 75 were the residual corneal tissues from corneo-conjunctival junction which were transplanted within stipulated time. Only one case showed changes of chronic actinic keratopathy, rest showed normal histology. 6 corneas which were not transplanted within stipulated time showed epithelial denudation and stromal degeneration with loss of keratocytes. Conclusion: Histopathology gives additional insight to clinical diagnosis. Specific diagnosis can be commented in corneal opacities and infectious keratitis.

To identify the reasons for refusing refractive surgery in patients visiting for spectacle-free vision. MethodologyMedical records of 296 patients who presented for keratorefractive surgery (KRS) from June 2017 to April 2020 at a tertiary eye care center in central India (Government Medical College and Hospital, Nagpur, Maharashtra, India) were reviewed. Demographic details of all the patients and parameters obtained during workup of a case presented for KRSs were captured in an Excel ® sheet and analyzed statistically. ResultsOf the 296 patients who presented for KRS during the study period, 86 (29.1%) patients were denied KRS. The mean pachymetry in the right eye was 505 μm ± 10 μm (range 520-485 μm) and 502 μm ± 7 μm (511-490 μm) in the left eye. Suboptimal corneal thickness (n = 28, 32.6%) was the most common reason for rejection. Other reasons for not recommending the procedure were high myopia (n = 20, 23.3%), spectacle not stable (n = 16, 18.6%), and keratoconus (n = 11, 12.8%). Collagen vascular diseases (n = 3, 3.5%) and anxiety about the procedure (n = 2, 2.3%) were causes unrelated to the procedure. No correlation was observed between corneal thickness and degree of myopia (r = 0.014, p = 0.66). ConclusionPatients presenting for KRS exhibit various problems. Meticulous preoperative evaluation is most important for long-term visual outcome. Suboptimal corneal thickness, high myopia, unstable spectacle correction, and keratoconus were the common reasons for not performing KRS in the study population.

BACKGROUND The aim of the study is to-1. Diagnose strabismic, anisometropic and mixed amblyopia in age group 5-15 years. 2. Analyse these patients for age, sex, type of refractive error, type of squint, type of fixation pattern and classify them aetiologically. 3. Study effectiveness of different amblyopia treatments in this age group. MATERIALS AND METHODS Patients in 5-15 years of age in a period of two years were selected and assessed for amblyopia, which included a detailed history, visual acuity, retinoscopy, ocular movements and alignment, slit lamp examination, fundus examination. Patients were given amblyopia treatment and assessed for improvement. Settings and Design-Hospital-based descriptive study in a period of two years. RESULTS In 32 amblyopic patients, maximum patients were of age group between 5-7 years. 53.12% of patients were females. Amblyopia was predominant among anisometropic patients (75%) with maximum of refractive error difference between 2.00 D to 4.00 D. Amongst them, maximum amblyopes were having hypermetropia with astigmatism (37.50%). In the strabismic type, esotropia was more common. Patients showing more than 2 Snellen's line improvements after patching for 2 hrs. were 77.27% and for 6 hrs. were 22.72%. After part-time patching, maximum improvement in BCVA (best corrected visual acuity) was seen in anisometropes (P<0.0001) followed by strabismic (P=0.025) and least with mixed (P=0.026) amblyopes. CONCLUSION Amblyopia is treatable if detected earlier. Lack of community or preschool vision screening was the main cause for late pickup of amblyopic children for timely management and hence significant visual impairment associated with the condition.

To evaluate the prognostic value of OTS in open globe injuries. MATERIAL METHOD: Retrospective analysis of 77 eyes with open globe injuries was done from 01/07/2013 to 31/12/2014. Patients were assigned raw score sum based on initial V/A, and ocular findings then classified into 5 categories for predicting final visual outcome based on ocular Trauma score (OTS). RESULT: We estimated final V/A in 77 cases of open globe injuries (64.93%) had raw score between 65.91 (category 3, 4) Six months after the injury, 42.85% patients of categories 1 (raw score 0-44) achieved V/A of PL/HM as compared to 17% in OTS study. 16 patients with raw compared to OTS study. We reported comparable visual outcome with OTS study except in category 1 & 2. CONCLUSION: OTS score is valuable in triage, patient counseling and decision making for the management of ocular trauma. We recommend that OTS should be used routinely for open globe injuries as it is a simple guide.

BACKGROUND Fundus fluorescin angiography (FFA) has been traditional gold standard for detection of cystoid macular oedema (CME) but nowadays optical coherence tomography (OCT) is used more often by to detect CME due to various conditions. Although FFA can assess CME qualitatively, OCT provides quantitative measurement of foveal thickness. The purpose of this study is to compare sensitivity of FFA and OCT for detection of CME and know the etiological distribution of CME and the ability of FFA and OCT in diagnosing CME in different aetiologies. METHODS A hospital based prospective observational diagnostic study was conducted in tertiary eye care centre in central India on 143 eyes of 103 patients. FFA and OCT findings in patients of CME diagnosed provisionally on fundus examination were studied. RESULTS Of total 103 patients studied, maximum patients 20 (19.42 %) were in age group of 55 - 59 years whereas minimum 6 (5.83 %) were in age group of 40 - 44 years. In 103 patients, 61 (59.22 %) were males and 42 (40.78 %) were females. Both eyes were involved in 41 (40.78 %) cases. Most common cause of CME was nonproliferative diabetic retinopathy (NPDR) 52 eyes (35.86 %), followed by branch retinal vein occlusion (BRVO) 32 eyes (22.06 %), then proliferative diabetic retinopathy (PDR) 14 eyes (9.6 %), central retinal vein occlusion (CRVO) 13 eyes (8.96 %). CME on OCT was seen in maximum of retinal vein occlusion patients - CRVO (84.61 %) and BRVO (84.37 %). Of 145 eyes, 114 (78.32 %) eyes had CME. CONCLUSIONS Most common cause of CME was NPDR followed by BRVO, PDR and CRVO. Sensitivity of OCT in comparison with FFA was 100 % with diagnostic accuracy of 81.38 %. Hence, one can use OCT as first modality investigation for diagnosis of CME. KEYWORDS Optical Coherence Tomography, Fundus Fluorescein Angiography, Cystoid Macular Oedema, NPDR

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