Purpose: Smoking is a global health problem with a high burden of smokers in India and the world as well. Smoking is a known eye irritant that may have a significant effect on the anterior ocular surface. Hence, the present study was aimed to investigate the effect of smoking on dry eye parameters, ocular surface, and central corneal thickness (CCT) and to compare the results with nonsmokers. Methods: In this cross-sectional study, 40 (80 eyes) smokers and 40 (80 eyes) age-matched nonsmokers were included. The severity of ocular surface disease symptoms was assessed by the Ocular Surface Disease Index (OSDI) tool. All participants underwent a series of measurements, that is, the Schirmer’s II test score and tear breakup time (TBUT). Tear meniscus height (TMH) and CCT were measured using anterior segment optical coherence tomography (OCT). Results: The mean value of all dry eye parameters was statistically different among the group of smokers and nonsmokers. The mean score of symptomatic assessment (OSDI) was observed to be significantly higher in smokers than in nonsmokers ( P < 0.0001), and dry eye parameters, that is, Schirmer’s score ( P = 0.0127), TMH ( P < 0.0001), and TBUT ( P < 0.0001) were significantly lower among smokers than nonsmokers. There was no significant difference in CCT between smokers and nonsmokers ( P = 0.06). Conclusion: Cigarette smoking has deteriorating effects on the ocular surface. Exposure to smoking was found to be associated with dryness of the eye. Further studies are needed on a molecular basis.
Aims: To evaluate the clinical and histological status of tear film in patients with unilateral pterygium. Settings and Design:Cross-sectional, case-control, doubleblinded study. Methods and Material:Cross-sectional study of both eyes of 102 patients with unilateral pterygium was conducted between March 2011 to December 2012. Patients were subject to fluorescein lower tear meniscus height (LTMH) evaluation, fluorescein tear break-up time (TBUT), Schirmer's test (using topical anesthetic), vital staining (viz. fluorescein, Rose Bengal and lissamine staining), LTMH imaging with anterior segment spectral-domain optical coherence tomography (OCT) cornea-anterior module (CAM-L and CAM-S), and conjunctival smear impression cytology. The normal eye acted as control. Statistical analysis used: fisher's t-test and chi-square test.Results: The study comprised of seventy males and thirtytwo females in the age-range 28-76years. The mean fluorescein LTMH, mean TBUT, mean Schirmer's test value, mean OCT CAM-S and CAM-L values in the normal control eyes were 0.36 ± 0.03 mm, 12.3 ± 1.9s, 13.4 ± 2.5 mm, 0.338 ± 0.082 mm and 0.325 ± 0.088 mm, respectively. The comparable values in eyes with pterygium were 0.24 ± 0.03 mm, 8.2 ± 1.4 sec, 9.2 ± 2.4 mm, 0.212 ± 0.046 mm and 0.204 ± 0.058 mm respectively. Goblet cell count was decreased in impression cytology. Conclusions:Both fluorescein and OCT LTMH were found to be significantly decreased (p<0.01) in eyes with pterygium compared to control eyes. Goblet cell count, TBUT and Schirmer's test values were also comparatively decreased. This study thus emphasizes that tear film abnormalities play a role in aetiology of pterygium and hence early institution of therapy for tear film stabilization can help prevent the disease. Keywords: Keymessage:This study emphasizes that tear film abnormalities play a role in aetiology of pterygium and hence early institution of therapy for tear film stabilization can help prevent the disease.
Introduction: In children uncorrected refractive errors have a profound effect on educational and psychosocial development hence it is necessary to estimate the prevalence both at the community and at the school level to aid planning and implementation of refractive error services in children. Objective: To determine the refractive status of 5 to 15 years old children attending government schools of rural areas of district Agra, Uttar Pradesh (UP), India. Method: Study conducted on 902 students of age group 5-15 years of randomly selected government schools of Bichpuri Block of district Agra. Children underwent visual acuity assessment and torch light examination, height and weight measurement. Children with VA ≤6/9 were further examined and cycloplegic retinoscopy, fundus examination, slit lamp examination and post mydriatic refraction was done. On the basis of values of cycloplegic refraction and post mydriatic refraction, refractive error was classified as myopia, hypermetropia and astigmatism. Statistical Analysis was done by applying Chi square test. Result: Out of 902 children, 125 children (13.86 %) were having refractive error of which 76 were myopic (8.43%), 39 were astigmatic (4.32%) and 10 were hypermetropic (1.11%). There was an increase in the overall prevalence of refractive error with advancing age. There was no significant association of refractive error with gender and nutritional status. Conclusion: Vision screening of school children is very useful for early detection and correction of refractive errors. Screening of the refractive errors in school should be carried out periodically and regularly.
Subacute sclerosing panencephalitis (SSPE) is a ravaging disease of the central nervous system caused by persistent mutant measles virus. The diagnosis of SSPE is based on characteristic clinical and EEG findings and demonstration of elevated antibody titres against measles in cerebrospinal fluid. SSPE may have atypical clinical features at the onset. Herein, we report an atypical case of SSPE in an adolescent with bilateral retinitis as the initial presenting feature. The disease progressed with an appearance of cognitive worsening, myoclonic jerks, periodic high amplitude generalized complexes on EEG, and elevated titers of measles antibodies in cerebrospinal fluid leading to the final diagnosis of SSPE. The case warrants a high degree of suspicion on ophthalmologist’s part to clinch the definitive diagnosis of not so common deadly disease.
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