Background: Refractive errors are the commonest cause of visual impairment in school children worldwide. They can be easily corrected by a pair of spectacles, only when they are used regularly. The purpose of present study is to document the actual rate of spectacle wear at the time of examination, assess principle determinants of spectacle wear and reasons for non-compliance among different demographic groups.Methods: 200 school children in the age group of 6-15 years with refractive errors were selected. The schools were visited without prior intimation to the students 3 months after the initial examination. Reasons for spectacle wear non-compliance were enquired.Results: 78 (39.0%) children out of 200 were compliant to spectacle wear, while 122 (61.0%) were non-compliant to spectacle wear. Main reason for not wearing spectacles was ‘teased about the appearance with spectacles’.Conclusions: School teachers should explain the risk of non-wearing of spectacles and benefits of spectacle wearing to both children and their parents. Most of the children were not compliant because they were teased about, did not like, or were not comfortable in their spectacles- all societal issues that could and should be addressed.

This review article highlights the newer diagnostic modalities and approaches in the medical management of infectious keratitis. A Medline literature search conducted to March 2014 has been included. Recent studies or publications were selected from international indexed journals using suitable key words. Development of specular microscopy and polymerase chain reaction (PCR) has a promising role as diagnostic modalities in infectious keratitis, especially in refractory cases. Previously fortified antibiotics have been the mainstay of treatment for bacterial keratitis. Recently, the advent of fourth-generation fluoroquinolones monotherapy has shown promising results in the management of bacterial keratitis. Corneal collagen cross-linking is being considered in the refractory cases. Topical natamycin and amphotericin B should be considered as the first choice anti-fungal agents in suspected filamentous or yeast infection respectively. Voriconazole and newer routes of administration such as intrastromal and intracameral injection of conventional anti-fungal agents have demonstrated a positive clinical response. Ganciclovir is a newer anti-viral agent with promising results in herpes simplex keratitis. Thus, introduction of newer diagnostic modalities and collagen cross-linking along with fourth-generation fluoroquinolones and newer azoles have a promising role in the management of infectious keratitis.

We report a case of Acanthamoeba keratitis with Curvularia co-infection. Acanthamoeba and fungal co-infection have been uncommonly reported in literature, worldwide. A classical history with a strong clinical suspicion and experienced laboratory personnel with systematic examination of corneal scrapings for bacterial, viral, parasitic and fungal causes are imperative for accurate diagnosis. Early diagnosis of Acanthamoeba keratitis or fungal infection followed by aggressive and appropriate treatment with effective agents is critical for the retention of good vision. Acanthamoeba keratitis is difficult to diagnose and, despite improvement in treatment options, may culminate in prolonged morbidity and significant loss of visual acuity. This case emphasizes the important role played by clinical microbiologists in making prompt diagnosis which can ultimately reduce visual morbidity.