BACKGROUND Meibomian gland dysfunction (MGD) is one of the causes of evaporative dry eye disease. It is the terminal duct obstruction of the Meibomian gland and is associated with glandular secretion changes. These changes lead to decreased amount of lipids secretion which accounts for instability of tear film leading to evaporative dry eye disease. Chronic smoking also causes irritative, burning eyes along with unstable tear film. We wanted to study the corelation of chronic smoking with Meibomian gland dysfunction. METHODS This is a hospital based observational cross-sectional study that enrolled a total of 100 subjects having Meibomian gland disease (MGD), out of whom 61 were smokers and 39 were non-smokers. All enrolled subjects underwent tear film breakup time (TBUT), Schirmer I test (SIT) and slit-lamp microscope examination of lid margin abnormalities, Meibomian gland expression as well as meibum. RESULTS Our study found that the patients with Meibomian gland dysfunction with the history of chronic smoking had a remarkably decreased value of tear film break up time (TBUT), Schirmer’s 1 Test which explains the dry eye symptoms as compared to MGD patients without smoking. No significant differences were seen in lid margin irregularity and meibum secretion. Meibomitis is found in 29 smokers with MGD and 5 non-smokers with MGD which is not significant. CONCLUSIONS Chronic smoking is associated with MGD. KEY WORDS Cigarette Smoking, Meibomian Gland Dysfunction, Tear Film Tests
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a complication developed in patients due to vaccination. High-risk factors like a prothrombotic state predispose such a condition. Due to the increase in vaccinations after the coronavirus 2019 (COVID-19) pandemic, the predisposition to risk factors has increased. Hence, complications occur at a very young age. This case report is of a young male who developed venous sinus thrombosis post the COVID-19 vaccination and was diagnosed and treated promptly.
One of the most important differentials for painless sudden loss of vision is CRVO (Central retinal vein occlusion). It is one of the leading diseases causing vision loss especially in elderly population. However, bilateral simultaneous CRVO in a young patient with no other co morbidities is rare. This case illustrates a young male of 40 years with no well-known comorbidities who experienced sudden onset diminution of vision in right eye followed by left eye in 2 weeks gap. No history of smoking, diabetes, hypertension, dyslipidemia or any other systemic disorders. Patient is not on any topical or systemic medications. There was no significant family history.On evaluation of right eye, the BCVA (best corrected visual acuity) was 6/36 and left eye was finger counting 3 meters. Intra ocular pressure in both eyes was 18 mm Hg. Anterior segment showed all normal findings. Dilated fundus evaluation in both eyes showed multiple superficial and deep hemorrhages with hard exudates and macular edema. OCT (Optical Coherence tomography) displayed macular edema in both eyes. Blood investigations showed all values within normal limits except Vitamin D levels which were found to be deficient.
This study aims to compare the ganglion cell complex changes in diabetic macular edema (DME) and central retinal vein occlusion (CRVO) macular edema using optical coherence tomography (OCT). MethodsThis was a hospital-based cross-sectional study conducted for six months. All patients having DME and CRVO macular edema presenting to the Ophthalmology Department at Acharya Vinobha Bhave Rural Hospital were included in the study. A detailed and comprehensive ophthalmic examination was performed, and OCT was done for each patient. ResultsThe incidence of both DME and CRVO macular edema were both found to be maximum in the age group of 61-69 years. DME is more common in males (62.86%) than females (37.14%); the same was observed in CRVO group: 54.29% were males and 45.71% were females. Macular edema showed a mean value of 370.11 in DME and 428.71 in CRVO. Thus, the CRVO group showed more macular edema than the DME group. The ganglion cell complex thickness showed a mean value of 58.47 in DME and 66.77 in the CRVO group, implying that the thickness reduced significantly in the DME group. ConclusionOCT provides quantitative measurement of the ganglion cell complex thickness, which helps monitor the course of macular edema secondary to CRVO and diabetes Mellitus and thereby provides an assessment of the prognosis of the disease as these two diseases in particular are major causes of blindness worldwide, and timely care and management can help in altering its course.
Corona Virus Disease 2019 (COVID 19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first identified in Wuhan city of China in December 2019. Since then, the disease has spread very rapidly which has led to the current pandemic. Secondary infections are reported now a days during the illness in Covid-19 patients of any age and patients recovered from COVID 19. The high-risk conditions prone for opportunistic infections are uncontrolled blood sugar levels, prolonged steroid usage and oxygen therapy. Mucormycosis is highly invasive secondary infection. Early diagnosis along with surgical and medical intervention and control of all risk factors plays a crucial role. Delay in presentation of patient to medical care is really challenging to the physicians and ENT surgeons.
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