Purpose: In 2020, in response to the emergence and global spread of the disease COVID-19, caused by a new variant of coronavirus 2019-nCoV, the government of India ordered a nationwide lockdown for 21 days, which was then extended to a total of over 50 days. The aim of this study is to assess the effect of the lockdown on ophthalmic training programs across India. Methods: An online survey was sent across to trainee ophthalmologists across India through various social media platforms. Results: In all, 716 trainees responded; the average age was 29.1 years. Results showed that majority of the respondents were enrolled in residency programs (95.6%; 685/716) and the others were in fellowship programs. About 24.6% (176/716) of the trainees had been deployed on 'COVID-19 screening' duties. Nearly 80.7% (578/716) of the trainees felt that the COVID-19 lockdown had negatively impacted their surgical training. Furthermore, 54.8% (392/716) of the trainees perceived an increase in stress levels during the COVID-19 lockdown and 77.4% (554/716) reported that their family members had expressed an increased concern for their safety and wellbeing since the lockdown began. In all, 75.7% (542/716) of the respondents felt that online classes and webinars were useful during the lockdown period. Conclusion: Our survey showed that majority ophthalmology trainees across the country felt that the COVID-19 lockdown adversely affected their learning, especially surgical training. While most found online classes and webinars useful, the trainees' perceived stress levels were higher than normal during the lockdown. Training hospitals should take cognizance of this and reassure trainees; formulate guidelines to augment training to compensate for the lost time as well as mitigate the stress levels upon resumption of regular hospital services and training. Going ahead, permanent changes such as virtual classrooms and simulation-based training should be considered.

Digital eye strain (DES) is an entity encompassing visual and ocular symptoms arising due to the prolonged use of digital electronic devices. It is characterized by dry eyes, itching, foreign body sensation, watering, blurring of vision, and headache. Non-ocular symp-

Wohlfahrtia magnifica larvae cause myiasis in mammals, mainly in sheep and rarely in human. In human it may infest the ear, eye, mouth or nose, damaging living tissues. We report a case of ocular myiasis in 1.5 years old child belonging to urban slum after history of minor injury on left upper lid due to fall from bed. The purpose of reporting this case is to highlight the ocular association of W. magnifica.

PurposeTo compare the efficacy and safety of latanoprost, bimatoprost, travoprost and timolol in reducing intraocular pressure (IOP) in patients with primary open angle glaucoma.MethodsThis was a prospective study conducted at a tertiary-care centre. One hundred and forty patients with newly diagnosed primary open angle glaucoma were randomly assigned to treatment with latanoprost (0.005%), bimatoprost (0.03%), travoprost (0.004%) or timolol gel (0.5%); 35 patients were assigned to each group. All patients were followed for 2, 6, and 12 weeks. The main outcome measure studied was the change in IOP at week 12 from the baseline values. Safety measures included recording of adverse events.ResultsThe mean IOP reduction from baseline at week 12 was significantly more with bimatoprost (8.8 mmHg, 35.9%) than with latanoprost (7.3 mmHg, 29.9%), travoprost (7.6 mmHg, 30.8%) or timolol (6.7 mmHg, 26.6%) (ANOVA and Student's t-tests, p < 0.001). Among the prostaglandins studied, bimatoprost produced a maximum reduction in IOP (-2.71; 95% confidence interval [CI], -2.25 to -3.18) followed by travoprost (-1.27; 95% CI, -0.81 to -1.27) and latanoprost (-1.25; 95% CI, -0.79 to -1.71); these values were significant when compared to timolol at week 12 (Bonferroni test, p < 0.001). Latanoprost and travoprost were comparable in their ability to reduce IOP at each patient visit. Ocular adverse-events were found in almost equal proportion in patients treated with bimatoprost (41.3%) and travoprost (41.9%), with a higher incidence of conjunctival hyperemia (24.1%) seen in the bimatoprost group. Timolol produced a significant drop in heart rate (p < 0.001) at week 12 when compared to the baseline measurements.ConclusionsBimatoprost showed greater efficacy when compared to the other prostaglandins, and timolol was the most efficacious at lowering the IOP. Conjunctional hyperemia was mainly seen with bimatoprost. However, the drug was tolerated well and found to be safe.

OBJECTIVE: The objective of the study was to assess the perceived utility and the impact of web-based teaching programs being conducted following the COVID-19 pandemic. METHODS: An online survey was sent to trainee ophthalmologists across India through various social media platforms. The responses were tabulated and analyzed. RESULTS: A total of 768 valid responses were recorded. Majority of respondents (52.2%) felt that the ideal duration for webinars was 1 hour or less. Factors that helped trainees in choosing a webinar were the topic (95.1%), the timing (53.6%), and the speaker list (42.4%). Residents indicated a preference for webinars to attend aimed at postgraduate residency training, more specifically clinical problem-solving. Further questions were answered using a 1-10 Likert scale (1: least useful and 10: extremely useful). The median score when asked for overall usefulness of the webinars in general was 8 (interquartile range/IQR: 2). The median response when asked about utility of webinars in enhancing theoretical knowledge was 8 (IQR: 2) and the median for utility of webinar-based teaching programs in enhancing practical knowledge/surgical learning was also 8 (IQR: 2). The median score when asked about the utility of the webinar programs in acquiring skills for writing research papers/thesis was 7 (IQR: 3). Connectivity issues, audio/voice issues, and the long duration of webinars were some of the problems faced while attending webinars. CONCLUSIONS: Ophthalmology trainees in India found online teaching programs and webinars to be useful in enhancing their theoretical knowledge and practical skills/surgical learning. Administrators and educational institutes should tailor online teaching programs as per the needs and preferences of the residents.

The mythological epic Ramayana gives a graphic account of a possible case of the Kleine-Levin syn drome in Kumbhkarna, the younger brother of the demon King Ravana. Kumbhkarna used to sleep for six months at a stretch, getting up for a short period in which he ate up herdsand herdsof peopleand animals and drank an enormous quantity of wine. At this rate, says the epic, he would have consumed all the three worlds within a short period were he not overcome by anotherlong spell ofsleep (Tulsidasa, 1942). In India in historic times only three casesof the Kleine-Levin Syndrome have been recognized (Prab hakaran et a!, 1970; Narayanan et al, 1972; and Agarwal and Agarwal, 1979).We have recently seena classic example. The patient, a 25-year-old, married, Hindu, government employee, had three episodes of abnormal behaviour, ravenous appetite and excessive sleep during three months. The details of these episodeswereasfollows:â€" (a) The patient had a high grade pyrexia, lasting 13 days, diagnosed and treated by his family physician as

Extramedullary plasmacytoma is a rare plasma cell malignancy, comprising 3% of the whole group. The involvement of orbit is even rarer since 80% of extramedullary plasmacytoma have been reported from upper respiratory tract, followed by gastrointestinal tract. The disease is thrice more common in males than females and is more common in 6th to 7th decade of life, but we are reporting a case of extramedullary plasmacytoma presenting as lacrimal gland tumor in a 59-year-old female. The correct diagnosis is essential since the disease is highly radiosensitive and responds well to radiotherapy unlike other malignancy in this region. A high index of suspicion with imaging and careful use of fine needle aspiration cytology helps in diagnosis and prompt treatment.

Purpose: The purpose of this study is to evaluate the post-lockdown challenges during Coronavirus disease 2019 (COVID-19) pandemic amongst the ophthalmologists in India. Methods: An online survey was sent to the practicing ophthalmologists across India. Data were collected from the responding ophthalmologists and analysed using Medcalc 16.4 software. Results: A total of 794 responses were obtained. Most respondents (51%) were in the age group 30–50 years and were in independent practice (40.05%). Almost three-fourth of ophthalmologists resumed their surgical services after a gap of more than a month post-lockdown. Almost a third of the respondents had significant reduction in their surgical workload during this period. Significant fear of contracting COVID-19 infection in the operation theatres was reported while moderate difficulty was found in procuring protective gear during immediate post-national lockdown period. Conclusion: The pandemic has changed the ophthalmic practice significantly, with patient and staff safety becoming areas of major concern. Both financial and psychological concerns affecting healthcare workers need addressing for continued patient care.