Visual outcomes in pediatric traumatic cataract

To study epidemiology, biometry and visual outcomes (with or without posterior capsulorhexis) in cases of pediatric traumatic cataract. This was a prospective observational study conducted on 30 children of traumatic cataract belonging to an age group of less than 16 years. All patients were subjected to detailed history and ocular examination. Patients underwent cataract surgery with or without intraocular lens (IOL) implantation. Posterior capsulorhexis with posterior optic capture was done in all patients presenting with primary posterior capsular opacity. All patients were followed up till 6 months and surgical outcomes in terms of Best Corrected Visual Acuity (BCVA), and visual axis opacification (VAO) were observed. Firecracker injury was found to be the most common causal agent, followed by arrow and ball injuries. Males were more commonly injured than females (70%:30%). Open-globe injury was more frequent than closed globe injury (CGI) (53.3%:46.7%). Anterior capsular rupture was the most frequent preoperative complication. Mean axial length was 22.53 which was not significantly different from the fellow eye. 3 patients were left aphakic, 10 patients underwent single piece IOL implantation and 16 patients underwent multipiece IOL implantation. Anterior chamber IOL (ACIOL) was implanted in one case. Intraoperatively 6 patients were found to have posterior capsular plaque and were implanted with multipiece IOL with posterior optic capture. Visual acuity significantly improved in 21 out of 30 eyes from baseline after cataract surgery (p<0.001). 9 patients (30%) had posterior capsular opacification (PCO) on follow up. Posterior capsular opacity in pediatric traumatic cataracts can be effectively managed with posterior capsulorhexis and posterior optic capture.

Surgical Preferences in the Management of Primary Pterygium among Anterior Segment Specialists

Purpose: The purpose of this study is to reflect anterior segment specialists’ current practice pattern regarding the management of primary pterygium. Methods: A 24-item survey regarding indications for surgery, different surgical techniques, use of adjuvant pharmacological therapy, type of intraoperative and postoperative pharmacological therapy, and the preferred treatment of early recurrences was sent to members of the Saudi Ophthalmological Society (SOS) and practicing cornea experts including consultants, specialists, and fellows in Saudi Arabia. Results: A total of 61 cornea specialists completed the questionnaire (response rate 49%). More than 95% considered the proximity of the pterygium to the visual axis an indication for excision. The most frequent technique for pterygium excision was extensive head and conjunctival resection, including the base (69%) and intermediate resection of the Tenon's capsule (53%). For conjunctival replacement, conjunctival autograft was preferred by 79%, amniotic membrane (54%), and simple conjunctival closure (46%). Interrupted vicryl sutures, fibrin glue, and combined sutures and tissue adhesive were the preferred graft fixation conveyed by 85%, 46%, and 34% of our experts, respectively. An estimated recurrence rate of 1-5% was stated by 29% of respondents and 46% reported recurrence within 6 to 12 months. Half of the respondents specified using mitomycin C intraoperatively to prevent early pterygium recurrences. When recurrence occurred, corticosteroid was the agent of choice. Conclusion: This study set out to reflect the practice pattern of anterior segment specialists regarding the management of primary pterygium, and it may serve as an insight for further studies to define the optimal management of pterygium.

Congenital Cataract Surgery: A Retrospective Analysis of 62 Patients in a Developing Country

Purpose. This study was aimed at describing our experience in congenital cataract surgery in a developing Country. Methods. A retrospective study was conducted in Amman, Jordan. The patients who were diagnosed with congenital cataract and underwent the surgery were included in the study. It was decided to use an intraocular lens if the corneal diameter was more than 10 millimeters. Results. The findings revealed that around 13 of the patients did not have any visual axis opacification, indicating that they were aphakic. Visual axis opacification was seen in 8 out of the total sample of participants. Eleven patients with obvious opacification of the visual axis were found to be pseudophakic after at least two procedures and were thus cleared. It was necessary to do a second surgery to rectify the visual axis opacification induced by pseudophakia, which was putting the patient’s ability to recuperate at danger. Three of them (or 12 percent) exhibited visual axis opacification, which is a rare occurrence. The intraocular lenses used in the remaining 24 patients were constructed of hydrophilic plastic. Conclusion. Patients are less prone to have visual axis opacification while implanted by hydrophobic intraocular lenses is something they should consider.

A Review on Management of Amblyopia

Amblyopia is a visual cortex neurodevelopmental condition cause am vision abnormalities during childhood. It is one of the most typical causes of vision loss at an early age. It occurs due to abnormal development of the visual cortex. The part receiving signals from the diseased eye does not receive it correctly and thus develops abnormally. This abnormal development during the critical period of growth of child results in brain damage. Depending on its aetiology the types of amblyopia are Strabismic amblyopia, Visual deprivation amblyopia, Anisometric, Ametropic, Meridional, Toxic amblyopia. Clinical features are visual acuity is reduced, the effect of neutral density filter, the Crowding phenomenon is present. Complications of amblyopia include a Lazy eye becoming weak permanently, the eye may move out from the visual axis (squints). When treating amblyopia, our goal is that the eyes will work together in unison at an equal level; this will create a clear vision in the lazy eye. Amblyopia is treated in various ways depending on the seriousness of the disease and the patient's age. Patching of the non-amblyopic eye, as well as treatment with drugs like atropine, are common treatments. Vision therapy and some modifications to spectacles and contact lenses have been discovered to be effective in treating amblyopia in recent years. Modern Treatment- Falling Blocks, Occlu-pad. With current breakthroughs in amblyopia therapy, the success rate of a multimodal strategy is also improving. The purpose of this review article is to present information on the management of amblyopia. Literature on AMBLYOPIA MANAGEMENT has been taken from PubMed, Scopus, Science Direct, and other internet resources.

Astigmatism in Infants: Study of Changing Visual Axis in Infants and Children

Background: Astigmatism is an abnormality within the curvature of the attention. It occurs when light rays strike a spherical lens obliquely, or the line of vision to its principal axis is not parallel. Refraction away from the axis occurs when light strikes a lens obliquely and distorts the image formed. Aim: This study aimed to look at the prevalence of against-the-rule, with the-rule, and oblique-axis astigmatism in children. The change in cylinder index of refraction power and alignment of astigmatism in babies and young children is studied. Methodology: To conduct the study and thoroughly search the literature separately, references and abstracts were reviewed. Books like Parson’s diseases of the Eye by Dr. Radhika Tandon and several articles, WHO website, etc., were referred. Results: The study relied upon many studies on refractions procured by the near-retinoscopy methodology that knowledgeable Refractionist accomplished. Conclusion: It can be concluded that young children have a high incidence of against (???) type of astigmatism and that after this age (which age?), most children are with the rule.

Good Visual Acuity Outcome from an Ocular Blast Injury with Proper Management in Dr. Soetomo General Hospital Surabaya, Indonesia

Introduction: Ocular blast injury related to fireworks most often causing corneal erosion (29%), conjunctival erosion (11%), and conjunctival foreign body (10%) with children are more often than adults (65.9%:34.1%), and males far more often than female (71.9%:28.1%). Knowing proper management is very important to achieve the best result. Case presentation: We describe an ocular blast injury that experienced broad erosion and multiple foreign bodies on the corneal and pericorneal surface in the left eye and visual acuity decreased. The foreign body was scattered, and the fluorescein test was positive. We did proper foreign body extraction, irrigation, and ocular bandage. It was treated with chloramphenicol 0.5% eye ointment and homatropine eye drop. In two months, the patient’s left eye had clear cornea with a small scar formation near the visual axis. The visual acuity was 6/7 and BCVA was 6/6 with S-0.5 C-0.5 A 50° correction. Conclusions: Patients with ocular blast injury limited to superficial cornea erosion and and conjunctival erosion have a reasonable probability of achieving the best visual acuity. Foreign body extraction, proper irrigation, and topical medication show promising results. Scar formation near the visual axis can disrupt visual acuity however can be corrected in this case it can be corrected with glasses. Furthermore, public promotion and regulation to control firework using are very important.

The Durability of Vaccine Efficacy against Ocular HSV-1 Infection Using ICP0 Mutants 0∆NLS and 0∆RING Is Lost over Time

Vaccines to viral pathogens in experimental animal models are often deemed successful if immunization enhances resistance of the host to virus challenge as measured by cumulative survival, reduction in virus replication and spread and/or lessen or eliminate overt tissue pathology. Furthermore, the duration of the protective response against challenge is another important consideration that drives a vaccination regimen. In the current study, we assessed the durability of two related vaccines, 0∆NLS and 0∆RING, against ocular herpes simplex virus type 1 (HSV-1) challenge in mice thirty days (short-term) and one year (long-term) following the vaccine boost. The short-term vaccine efficacy study found the 0∆RING vaccine to be nearly equivalent to the 0∆NLS vaccine in comparison to vehicle-vaccinated mice in terms of controlling virus replication and preserving the visual axis. By comparison, the long-term assessment of the two vaccines found notable differences and less efficacy overall as noted below. Specifically, the results show that in comparison to vehicle-vaccinated mice, the 0∆NLS and 0∆RING vaccinated groups were more resistant in terms of survival and virus shedding following ocular challenge. Moreover, 0∆NLS vaccinated mice also possessed significantly less infectious virus in the peripheral and central nervous systems but not the cornea compared to mice vaccinated with vehicle or 0∆RING which had similar levels. However, all vaccinated groups showed similar levels of blood and lymphatic vessel genesis into the central cornea 30 days post infection. Likewise, corneal opacity was also similar among all groups of vaccinated mice following infection. Functionally, the blink response and visual acuity were 25–50% lower in vaccinated mice 30 days post infection compared to measurements taken prior to infection. The results demonstrate a dichotomy between resistance to infection and functional performance of the visual axis that collectively show an overall loss in vaccine efficacy long-term in comparison to short-term studies in a conventional prime-boost protocol.

Optical Design of a Shortwave Infrared Dual Camera CASSI Based on Improved Offner-Wynne Imaging Spectrometer

Based on the optical system characteristics of coded aperture snapshot spectral imager (CASSI), an optimized optical system of shortwave infrared dual camera CASSI was designed based on improved Offner-Wynne imaging spectrometer. The operating wavelength of the optical system ranges from 900nm to 1700nm, and the focal length is 1200mm. It consists of two parts: the two dimensional imaging system and the multispectral CASSI imaging system. The key technical parameters of the two parts are the same and there is no visual axis difference. Therefore, the optimized optical system can effectively improve real-time performance, optical transmittance and compactness of the dual camera shortwave infrared CASSI, which is conducive to the application in optical measurement scenes in the shooting range.

Sutureless Tectonic Mini-Descemet's Stripping Automated Endothelial Keratoplasty (“mini-DSAEK”) for the management of corneal perforations

Purpose To report the outcomes of a new technique, pull-through sutureless ‘mini-DSAEK’, to manage corneal perforations secondary to different aetiologies including trauma, neurotrophic ulcer following penetrating keratoplasty (PK), herpes simplex keratitis and microbial keratitis. Methods In this retrospective case series, we report the clinical outcomes of five cases of sutureless tectonic mini-DSAEK performed in patients presenting with large corneal perforations to Southend University Hospital between November 2019 and October 2020. One corneal perforation was sufficiently peripheral for the tectonic mini-DSAEK graft to be successfully positioned outside of the central visual axis. Four corneal perforations were central or paracentral for which the tectonic grafts involved the visual axis. Results Anterior chambers remained deep and formed with no evidence of leak in all subsequent follow ups in all patients representing 100% tectonic success. All tectonic grafts remained attached except one partially detached graft. One patient underwent uneventful phacoemulsification with intraocular lens implant 8 months after the primary intervention with excellent visual outcome. Two patients underwent two-piece mushroom PK and one patient underwent triple procedure (cataract extraction + intraocular lens + PK) for visual rehabilitation 2–6 months after the primary intervention with good visual outcome. Conclusion Sutureless tectonic pull-through mini-DSAEK is a useful technique in the management of corneal perforations, with a number of advantages compared with conventional techniques.