Background: Ocular manifestations of HIV infections are common in the developing countries with lacking data in rural areas. The aim of study was to assess the prevalence of ophthalmic manifestations among HIV infected individuals in rural population and to find the relationship between CD4 count and ocular manifestations among these individuals.Methods: Authors have included 400 HIV patients of age more than 15 years that were registered in ART center of our institute. Ocular examination was done with slit lamp biomicroscope and indirect ophthalmoscope. Blood sample was sent for CD4 count analysis.Results: The mean age of patients ware 31.9±9.3 years, the ocular manifestations were more commonly found in the age group 25-35 years. 51 % were males and 49% were females. Most common mode of transmission was heterosexual contact (51%).55 % patients had CD4 count >150 cell/cumm. Cotton wool spots (36%) and intra-retinal haemorrhages (32%) was most common posterior segment findings followed by ocular toxoplasmosis (13%), CMV retinitis (10%), acute retinal necrosis (3 %).Conclusions: The prevalence of ocular manifestations in HIV patients is high and is a burden for our society, authors recommend screening of all the HIV patients to detect any vision threatening ocular lesions at the earliest.

We present a case of unilateral non-ischemic CRVO in a 22 year male without hypertension, diabetes and open angle glaucoma. Laboratory tests including complete coagulation profile and thrombotic workup were negative, except for raised serum homocysteine level(23.03 µmol/L). The patient was given vitamin supplements for 8 weeks to control homocysteine levels and a single intravitreal bevacizumab injection was given to treat macular edema. The vision and macular thickness improved to normal at 8 weeks, with no recurrence or new cardiovascular complications over a follow-up of one year. We also reviewed the literature and found hyperhomocysteinemia to be a important risk factor for CRVO in the young, and vitamin supplements help in quicker recovery and can prevent recurrence.

Background: Age-related macular degeneration (ARMD) is the major challenge in the new millennium in the developing countries as the size of elderly population continues to rise due to betterment of medical facilities and increased life expectancy. Lipids are implicated in the pathogenesis of ARMD. The relationship between systemic lipids and ARMD has not been well characterized, especially in rural population. The objective was to investigate the relationship between serum lipids and ARMD in older adults.Methods: In this case-control study, 300 adults, aged ≥50 years, 150 each among cases and controls were included in the study. Mean lipids values between cases and controls were compared.Results: Mean age of cases was 62.45±8.472 years and mean age of controls was 61.89±8.51 years. Among 150 cases, 124 (82.66%) cases were of dry ARMD while 26 (17.33%) cases were Wet ARMD. Author found that 38 cases among total cases (25.33%) and 15 individuals (10%) among controls had altered lipid profile. All mean lipid values were higher among cases compare to controls (p>0.05), while the mean of VLDL, TG and TG/HDL were significantly raised showing positive association (p<0.05).Conclusions: Present study showed that high levels of serum lipid values especially VLDL, TG and TG/HDL positive association with an increased risk for development of ARMD, implying that strategies reducing serum lipid levels may be useful to prevent the development of the disease.

Background: Pterygium is a common ophthalmological problem in India. Excision of pterygium with conjunctival autograft is the main line of treatment. Many modifications of surgical techniques have been tried like conjunctival autografting with fibrin glue, sutures and autologous serum. All these modalities have their pros and cons. We compared these techniques for conjunctival autografting following pterygium surgery. Methods: A randomized interventional study was performed on 60 eyes with primary nasal pterygium. After pterygium excision, the bare sclera was covered with a conjunctival autograft, which was fixed using autologous blood serum(in Group A, n=20), fibrin glue(in Group B, n=20) and vicryl suture (8-0) (in Group C, n=20). The patients were examined on postoperative Day 1, 1 week, 1month, 3 month and 6 month. The main outcome measures were operative time ,autograft stability, postoperative discomfort, autograft thicknes, pterygium recurrence and granuloma formation. Results: The mean operative time was significantly shorter in group A(23.60 min) followed by Group B (25.20 min) and Group C(28.15 min)(p-value <0.0001).Postoperative discomfort measured on visual analogue scale was minimal in fibrin group (p-value=0.0008) and maximum in suture group. Graft displacement was found in 2(10%) patient in autologous blood group (p value=0.349) while Graft oedema, granuloma & recurrence was noted in suture group only(p value=0.362). Conclusions: The conjunctival autografting with fibrin glue proved to be better method than autologous serum and suture, as it had very less postoperative discomfort, no recurrence, minimal edema and less graft displacement.

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