When you wake up in the morning do you read the paper? Watch the news? Or instead do you scroll through the multitude of applications on your phone or computer checking various social media sites, news outlets, or magazine articles? If you do not, you are in the minority. We are living in the age of information. At no other time in human history has there been such seamless, immediate access to information. But is that for the best? It has become expected in this era of instant gratification to feel comfortable with free, instant, and many. We want options. 47% of the global population uses the internet. We believe that universal access to knowledge is a human right in the same way that many fight for the equality of opportunity. However, as we navigate the uncharted territory of technology, we must be diligent and cautious.
How to cite this article: Bhartiya S, Clement C, Dorairaj S. The Open-Access Journal Controversy. Cli Exp Vis Eye Res J 2018;1(1):1-2.
Aim: The aim of this study is to examine and compare the effect of treatment zone diameter on the results of femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and trans- photorefractive keratectomy (PRK) procedures performed for the treatment of myopia.
Materials and Methods: This was a retrospective cohort study. The study reviewed medical files of patients who underwent trans-PRK (2630 eyes) and FS-LASIK (879 eyes) in which different treatment area diameters were used. For each type of surgery, the eyes were divided into three groups, based on the treatment zone diameter (6 mm, 6.5 mm. and 7 mm).
Results: In the FS-LASIK group, there was no difference in both the safety and efficacy indices or in the distance from the intended result between the groups (P = 0.79, P = 0.57, and P = 0.09, respectively). In myopic trans-PRK, a treatment area of 7 mm was associated with worse outcomes in terms of safety (P = 0.01) and efficacy (P < 0.01) in comparison with the other groups. In addition, a treatment zone of 7 mm was associated with a significantly larger distance from the refractive target (P < 0.001). There were no significant differences between the 6 mm and 6.5 mm groups in any outcome measure. These results recurred in a multivariate analysis, after correcting them for age, gender, pre-operative refractive error, and pachymetry.
Conclusions: Different treatment zone sizes gave similar results in FS-LASIK, while in trans-PRK, a 7 mm zone was associated with inferior outcomes in comparison to smaller treatment zones. Hence, in trans-PRK, we recommend choosing a treatment zone smaller than 7 mm while taking pupillometry into account and opting FS-LASIK whenever a very large treatment zone is required.
Laser-assisted in situ keratomileusis, optic zone, photorefractive keratectomy, refractive surgery, treatment zone
How to cite this article: Gershoni A, Knaneh S, Mimouni M, Livny E, Bahar I, Nahum Y. Effect of treatment zone diameter on the clinical results of femtosecond laser-assisted in situ keratomileusis and trans-photorefractive keratectomy for the correction of myopia. Cli Exp Vis Eye Res J 2018;1(1): 3-8.
Aim: This study aims to study the presentation pattern of primary congenital glaucoma (PCG) in Northern India and analyze the relationship to its outcome if any. Methods: A total of 90 patients (157 eyes) with PCG presenting between January 2003 and December 2011, with at least 1-year follow-up after surgery were included in the study. Inclusion criteria were increased corneal diameter (>12.0 mm), intraocular pressure (IOP) >18 mmHg and/or presence of Haab’s striae with or without optic disc changes. Demographic data, whether the patient was self-reported or doctor referred, presenting IOP, corneal diameter, corneal clarity, and optic nerve damage where visualized, were recorded. Outcome of treatment was determined depending on IOP control and requirement of drugs. Differences in presenting feature between self-reported and doctor-referred patients, and association between presenting features and outcome was analyzed.
Results: Majority (67%) were self-reported. 102 eyes had hazy corneas; 45 eyes (28.7%) presented with corneal opacity. Doctor-referred patients presented earlier (P < 0.001), had significantly lower IOP (P = 0.009), and smaller corneal diameters (P = 0.049) than self-reported. Good outcome was correlated with lower IOP (P = 0.005) and smaller cornea (P < 0.001) at presentation. Corneal opacity at presentation was strongly correlated to poor outcome (P < 0.001). Optic disc cupping at presentation had no bearing on the final outcome.
Conclusions: Corneal involvement appears to occur early in this cohort of PCG. Corneal examination under torchlight by paramedical personnel, general physicians, and pediatricians might lead to an early referral before vision-threatening complications develop. However, early corneal involvement may indicate more severe disease and is likely to have a poor prognosis regardless of the time of referral.
Outcome, presentation, primary congenital glaucoma
How to cite this article: Kaushik S, Kaur S, Dhiman IB, Gupta A, Raj S, Pandav SS. Spectrum of presentation in primary congenital glaucoma and its relation to the early outcome. Cli Exp Vis Eye Res J 2018;1(1):9-13.
Background: Orbital circulation is influenced by systemic hormonal status. Ocular pulse amplitude (OPA) is a surrogate measurement of choroidal blood flow. We investigated the OPA profile during different stages of pregnancy. Design: Cross-sectional study.
Participants: We enrolled 24 pregnant and 25 non-pregnant women (age-matched controls).
Methods: Data collected included age, pregnancy period, intraocular pressure (IOP), and central corneal thickness (CCT). Pascal dynamic contour tonometry was used to measure OPA values. The mean of three good quality measurements was used for the analysis. Whenever both eyes were eligible, the right eye was arbitrarily selected. Main Outcome Measures: Differences in OPA values between pregnant women (at each trimester) and non-pregnant controls.
Results: Mean age and CCT were similar between pregnant women (27.8 ± 6 years, 547 ± 25 um) and controls (28.9 ± 3.4 years, 546 ± 28 um; P > 0.25). Pregnant women (mean gestation period, 20.4 ± 9 weeks) had a lower mean IOP than controls (11.4 ± 2.4 vs. 13 ± 2.1 mmHg; P = 0.02). Analysis of covariance (adjusting for IOP difference) revealed that OPA values in women in the 1st (3 ± 0.6 mmHg) and 2nd trimesters (2.5 ± 0.7 mmHg) of pregnancy were increased compared to those in the last trimester (1.8 ± 0.6 mmHg) and controls (2.1 ± 0.7; P < 0.05). Multivariate analysis showed that gestation period was the only variable associated with OPA values during pregnancy (r2 = 0.30, P < 0.01). Age, CCT, and IOP were not statistically significant in this model (P > 0.5). Conclusions: Our results suggest that OPA values are increased in the first two trimesters of pregnancy, returning to normal in the last 3 months. These changes in OPA values seem not be influenced by age, CCT, or IOP.
Dynamic contour tonometry, ocular pulse amplitude, pregnancy
How to cite this article: Fernandez LA, Sousa AKS, Doi LM, Dorairaj S, Filho CAG, Paranhos A, Prata TS. Analysis of ocular pulse amplitude values in different pregnancy stages as measured by dynamic contour tonometry. Cli Exp Vis Eye Res J 2018;1(1):14-17.
Purpose: The purpose of this study was to assess the reliability of spectral-domain optical coherence tomography (OCT) as a diagnostic tool in the detection of an attached posterior vitreous.
Methods: A double-blind comparison of the vitreous imaged by OCT acquired on the day of surgery with the status of the posterior vitreous assessed at the time of surgery. Results: A total of 103 patients were recruited to the study, 67 of whom had complete data and were included in the analysis. 37 eyes had macular holes (MHs), 23 eyes had epiretinal membranes (ERM), and the remaining 7 eyes had other macular pathology, including vitreomacular traction syndrome and lamellar holes. The overall sensitivity of OCT in detecting an attached posterior vitreous was 80% and the specificity was 56%. For MH, this was 88% and 60%, respectively, whereas for ERM, it was only 45% and 50%.
Conclusions: The assessment of attachments of the posterior hyaloid membrane on OCT can reliably predict attached posterior vitreous in MH but not in ERM.
Epiretinal membranes, macular holes, optical coherence tomography, posterior vitreous detachment, pre-operative assessment
How to cite this article: Aristodemou P, Brelen ME, Kumar N, Markham R Haynes RJ, Dick A. Optical coherence tomography assessment for attached posterior vitreous in eyes with macular holes and epiretinal membranes. Cli Exp Vis Eye Res J 2018;1(1):18-22.
Delayed visual maturation (DVM) is the condition wherein infants who appear blind at birth regains normal or near normal vision with time. We describe the modes of presentation along with an approach to the visually inattentive child and a differential diagnosis of the condition. We discuss the electrodiagnostic findings and indications for further investigation. The pathophysiology of DVM is not known, but it may be due to a fault of the sensory, motor, or visual attention systems, and these hypotheses are described in detail. Finally, the term “temporary visual inattention” is proposed as a more accurate term that best describes our current understanding of DVM.
Delayed, infants, maturation, vision
How to cite this article: Tatham A, Jain S. Survey of ophthalmology. Cli Exp Vis Eye Res J 2018;l(l): 23-34.
Ophthalmic pharmaceutical markets are expanding and growing globally and in India. This review article gives a glimpse of the current pharmaceutical market globally and compares the international ophthalmic drug markets with the scenario in India with further insights into the relative contribution and growth from individual ophthalmic therapy segments as well as a look at future ophthalmic drug pipeline.
Markets, ophthalmic, pharma
How to cite this article: Narayanan V. Pharmaceutical ophthalmic market perspectives in India and emerging trends. Cli Exp Vis Eye Res J 2018;l(l):35-37.
The spectrum of pediatric orbital tumors differs from that of adults and further varies according to age. Tumors seen in teenage are similar to those seen in adults, while congenital space-occupying lesions such as colobomatous cyst and teratoma form an entity unique to infancy and early childhood. There is a vast difference in the management of orbital disease in children as opposed to adults in view of the different challenges faced.
Pediatric, orbital, tumors
How to cite this article: Meel R. Pediatric orbital tumors - An overview. Cli Exp Vis Eye Res J 2018;l(l): 38-43.
Received 16 April 2018;
Accepted 30 June 2018
Amblyopia is the most common cause of monocular vision loss in children and population under 40 years, with an estimated prevalence of l-5%. Amblyopia is caused by a prolonged period of abnormal retinal stimulation due to strabismus (ocular misalignment), anisometropia (refractive imbalance), or both (combined) and leads to functional deficits including reduced contrast sensitivity, poor spatial localization, poor stereovision, and foveal crowding. The present treatments for amblyopia are predominately monocular, aiming to improve the vision in the amblyopic eye. Recent evidence shows that amblyopes possess binocular cortical mechanisms for both threshold and suprathreshold stimuli. Hence, there is an ongoing search for binocular stimulation methods. Detecting the condition early increases the chances of successful treatment and the earlier it is detected, more successful will be the treatment in equalizing vision in both eyes. If it is not treated timely, it can cause permanent loss of vision. This article reviews the recent advances in amblyopia management and how they can be put to clinical practice.
Amblyopia, lazy eye, penalization, patching therapy
How to cite this article: Kaur S, Dadeya S. Binocular Treatment of Amblyopia. Cli Exp Vis Eye ResJ 20l8;l(l):44-47.
Received 14 July 2018;
Accepted 24 July 2018
This study was aimed to describe a case study of a 75-year-old male patient with aphakic pupillary block. Angle-closure glaucoma is a sight-threatening condition. Pupillary block is often a component of angle-closure glaucoma that has multiple possible etiologies. Prolapse of vitreous through the pupillary aperture as a cause of pupillary block is uncommon. Although laser iridotomy is the mainstay treatment in pupillary block, it is not always an effective treatment strategy for this particular clinical scenario. A 75-year-old male presented to the emergency department with symptoms and signs compatible with aphakic acute angle closure secondary to vitreous prolapse through the pupillary aperture, causing pupillary block. The patient was treated with topical intraocular pressure (IOP) lowering agents and systemic hyperosmotics resulting in a moderate decrease in IOP. Treatment attempt to relieve the pupillary block component with Nd: YAG laser iridotomy was ineffective. The second attempt at Nd: YAG laser aimed at the vitreous bubble protruding through the pupillary aperture was successful, with immediate aqueous humor flow and deepening of the anterior chamber, IOP decrease, and resolution of symptoms. Anterior segment photographs and anterior segment optical coherence tomography (AS-OCT) scans obtained before and following the procedure were useful in evaluating and documenting the clinical scenario and eventual vitreous block resolution. We report an unusual case of vitreous pupillary block and treatment strategy using Nd: YAG laser vitreolysis. Anterior segment imaging, particularly AS-OCT, is a useful auxiliary test for evaluation and documentation in such complex cases.
Nd: YAG laser, pupillary block, vitreous prolapse
How to cite this article: Barnir EM, Hadayer A, Geffen N, Zahavi A. Aphakic pupillary block: A case study and review of the literature. Cli Exp Vis Eye Res J 20l8;l(l): 48-50.