Introduction: HIV/AIDS is a disorder which affects multiple systems in our body but ophthalmic manifestations do occur in 70-80% of patients sometime during their lifetime. Eye is affected either directly by HIV virus or indirectly through various opportunistic infections. HIV related ophthalmic manifestations are wide and can affect any part of eye from a dnexal disorders to posterior segment diseases including the optic nerve and the optic tract. This study was done to know the prevalence of ocular manifestations in the known HIV positive case & to correlate the ocular manifestations in HIV positive patients with their CD4+ lymphocyte count and duration of disease. Material & Methods: In the present study, we examined 200 known cases of HIV infection who attended the Out Patient Department of Government Eye Hospital, Amritsar, Punjab. Detailed ocular examination was done and the findings were correlated with CD4+ count and duration of the disease. Result: In the present study it was found that dry eye and HIV retinopathy were amongst the most common ocular manifestations accounting for 20.5% and 20% of the total cases. Next in the series was neuro ophthalmic complications which include dpapilledema, optic nerve atrophy, papillitis and also third nerve abnormalities. It consisted of 5.5% of the total cases. Almost equal in incidence was anterior uveitis consisting of 5% of the total. Next of importance was CMV retinitis of which 5 cases were seen which constituted 2.5% of the total and all these cases were observed in the patients with CD4+ count less than 50/mm3. p value for this was 0.008 which was statistically significant. Few cases of blephar it is, conjunctivitis, cellulitis, herpes zoster ophthalmic us and keratitis were also found which consisted of 2.5%, 0.5%, 1%,3%, and 2% respectively. Conclusion: Any HIV-infected person who at any stage experiences ocular symptoms also should get competent ophthalmologic care at the earliest. Any delay in treatment can lead to permanent visual loss. An improved coordination between two branches of ophthalmology and HIV medicine will need long coordination against this dreadful disease.

Solid-state 532 nm green laser is a safe and effective treatment for high-risk retinopathy of prematurity.

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Purpose: The aim of this study was to evaluate and compare the presence of SARS-CoV-2 in tears of patients with and without ocular symptoms in SARS-CoV-2 positive patients. Methods: The prospective observational study conducted on 60 consecutive SARS-CoV-2 positive patients with ocular complaints was compared with 60 controls who had no ocular manifestations. The tear samples were taken within 48 h of admission from both the eyes of the enrolled patients for evaluating the presence SARS-CoV-2 by reverse transcription-polymerase chain reaction. Results: Eleven cases (18.33%) tested positive for SARS-CoV-2 in tears on RT-PCR from cojunctival swab compared to 10 (16.66%) controls. The difference was not statistical significant. The difference between mean age of patients who tested positive or negative was also without statistical significance ( P = 0.652), but the difference between patients who tested positive or negative by conjunctival swab for SARS-CoV-2 was statistically significant in terms of severity of COVID-19 disease ( P = 0.0011), presence of comorbidity ( P = 0.0015), mean TLC ( P = 0.00498), and mean d dimer ( P = 0.00465). Conclusion: Though the percentage of patients with positive RT PCR from conjunctival secretions is significantly less than nasopharyngeal swabs, potential risk of transmission of SARS-Co-2 through tears cannot be ruled out. Moreover, SARS-CoV-2 can be present in tears irrespective of ocular involvement.

Background: Type 2 diabetes mellitus (DM) is now considered as a growing global public health concern due to cost associated with diabetic micro and macrovascular complications. Diabetic retinopathy (DR) is one of the leading causes of vision loss. Accurate estimation of prevalence of DR among diabetic patients and associated risk factors are of crucial importance to plan and execute preventive strategies in the community. Aims and Objectives: The present cross sectional hospital based observational study was undertaken to determine the prevalence of DR in diabetic patients at their first ophthalmological contact and toevaluate associated risk factors. Materials and Methods: In this cross sectional hospital based observational study, all diabetic patients visiting ophthalmology clinic for the first time after being diagnosed as diabetic were enrolled. After recording demographic data and biochemical findings, each patient was investigated for DR and correlated with associated risk factors. Results: Of 1699 patients, majority (68.9%) of them had come to ophthalmology clinic with complaint of decreased vision. Only 16.12 % (274) patients had been referred for retinal exam by treating physician. DR was prevalent in 242(16.98%) non-referred and 31(11.31%) referred patients. Mean age and mean duration of diabetes was significantly higher in non-referred patients. Vision threatening DR was also significantly higher in nonreferred patients. Prevalence of DR was significantly correlated with age at presentation, duration of diabetes, rural background, uncontrolled diabetes, systolic blood pressure and high BMI. Conclusion: Low referral by treating physician and lack of awareness among patient accounts for late presentation of diabetic patients to ophthalmologist. Beyond just developing strategies to promote screening programs for early detection and management of DR, education of the patients,comprehensive planning and coordination between ophthalmologist and physician can go a long way to decrease the economic and social burden of preventable blindness due to diabetic retinopathy.

AIM: The aim of this study was to study the effect of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser iridotomy on corneal endothelial cell count in patients with subacute angle closure using specular microscope. MATERIALS AND METHODS: In this prospective study, 50 cases of narrow-angle Grade 1 and Grade 2 (Shaffer gonioscopic grading) visiting the Regional Institute of Ophthalmology, Government Medical College, Amritsar underwent Nd:YAG laser peripheral iridotomy. After obtaining informed written consent, specular microscopy was performed before and after iridotomy at 1 week, 1 month, 3 rd month, and at 6 th -month follow-up visits. Central, nasal, and temporal endothelial cell counts were evaluated through noncontact specular microscopy. RESULTS: The mean participant age was 51.52 ± 7.9 years, and majority of the participants were females (76%). The mean IOP before the laser was 19.25 ± 1.914 mmHg and it varied from 18.50 ± 1.647 to 18.25 ± 1.699 mmHg (day 1, p = 0.06 and at 6 months, p = 0.04) following laser procedure. The mean corneal endothelial cell count at superotemporal site before laser peripheral iridotomy was 2844 ± 260, and this value decreased to 2807 ± 263, 2699 ± 267, 2656 ± 270, and 2591 ± 275 cells/mm 2 at postiridotomy, 1, 3, and 6 months’ follow-up visits, respectively; these differences were statistically significant ( p < 0.05). The mean total energy required to produce iridotomy was 14.88 ± 6.71 mJ, ranging from 5 to 37 mJ. The linear regression analysis indicated no statistical correlation between change in endothelial cell count at the treated site and total mean energy used. No significant difference was found between preiridotomy and postiridotomy corneal thickness at any site. CONCLUSION: This study demonstrated a significant endothelial cell loss at the treated site in 6 months’ follow-up and suggested that Nd:YAG laser iridotomy may pose hazard to the corneal endothelium, although corneal decompensation at the treated site or as a whole was not seen.

Background: Idiopathic Intracranial Hypertension (IIH) is characterised by raised intracranial pressure (ICP) with normal cerebrospinal fluid (CSF) composition and absence of hydrocephalus or space occupying lesions. IIH is a rare disease in children. It can lead to visual impairment but prompt diagnosis and treatment in most of the cases will prevent potentially permanent visual loss. Objective: To report a rare case of Idiopathic Intracranial Hypertension in a pubertal child, clinical features, and findings of Magnetic Resonance Imaging (MRI) and visual field of this case. Case: An adolescent girl aged 14 years presented with headache and transient visual obscuration for two weeks. On examination, findings (fundus, visual field and MRI) were suggestive of Idiopathic intracranial hypertension. She did not have any classical predisposing risk factors. She recovered very well with acetazolamide and short term steroid therapy with no sequelae and clinical recurrence over a follow up of 12 months. Conclusion: This is a rare case of IIH in a child, which was confirmed on the MRI and visual field testing.

Aim:To study the effect of YAG laser capsulotomy on visual acuity with special reference to IOP changes and its correlation to the energy used in pseudophakics. Materials and Methods: A total of 120 cases of pseudophakic eyes having intraocular pressure (IOP) between 10-20 mmHg were included. After detailed history and ocular examination including visual acuity, slit lamp biomicroscopy, fundus and applanation tonometry, laser capsulotomy was performed to clear off 4-5mm visual axis. High (>50mJ) and low (<50mJ) energy groups were divided according to the energy used during procedure. Post-laser IOP was noted immediately, at 1 hour, 2 hour, 4 hours, 24 hours, seventh day and on 1 month by Goldmann applanation tonometer. Results: 95% of the cases showed improved visual acuity, after laser capsulotomy. Elevated IOP was seen in 75 cases, out of which 80% of them showed transient IOP rise within 2 hour whereas no elevation was seen in 45 cases. IOP change was significantly high in high energy group (p=0.000) than in low energy. Conclusion: Post-laser IOP rise is minimal and transient. It varies with the amount of energy used. Routine pre and post antiglaucoma medication can be avoided and minimal laser energy should be used.