Bhavna Govindaraj

Abstract

Purpose: The aim of this study was to identify the clinical profile and the likely causative factors for eyelid lacerations at a tertiary eye care centre in South India. This was done so that the data can be used to identify the most common patterns of injuries, using which effective safety measures can be developed. Materials and Methods: A retrospective study was done through a review of hospital records of 57 cases of traumatic eyelid lacerations who presented to our centre in the period between Jan 2017 to Jan 2018. The data collected were related to epidemiological factors, causative factors, site of injury, structures involved and association with visual outcome. Results: Of the 57 patients included in our study, 39 were men & 18 were women. The mean age of patients was 17+_ 2.8 years. As far as the location of injury was concerned, 67.32% patients sustained them while outdoors, 10.52% at home, 23.16% at their workplace. The most common mode of injury was by trauma caused accidentally in 36 patients (63.15%), assault in 11 patients (19.29%), falls in 10 patients (17.54%), laceration involving either the punctum or canalicular drainage system were seen in 33.26% patients. Based on the Snellen chart visual acuity of the injured eye/s was as follows: in 54 patients (90.6%), the visual acuity was better than 6/60; while in 3 patients (9.4%), the visual acuity was worse than 6/60.   Keywords: Eyelid laceration, Traumatic eye injuries

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Purpose: To evaluate the changes relating to lower lid position and laxity after cataract surgery. Materials and Methods: This is prospective study evaluating the lower eyelid position of patients who underwent cataract surgery from June to September 2019. Data collected includes duration of the cataract surgery, the duration of the speculum remaining insitu. Also we included measurements relating to the distraction test, distance of the lower lacrimal punctum from the inner canthus, and margin reflex distance 2 (MRD2) were performed 1 day, 2 weeks & 3 months post surgery. The data was analysed in Microsoft Excel & SPSS software. Results: The study sample comprised 109 cataract patients, all of whom were of South Indian ethnicity, 68 (62.3%) were female with a median age of 74 years, and 67 (61.4%) had surgery in their left eye. The distraction test before surgery was 6.5 ± 0.2 mm, with mild increase after 1 day (7.3 ± 0.3 mm), sustained after 14 days (7.5 ± 0.2 mm), and decreasing after 3 months (7.0 ± 0.5 mm) to a level similar to the initial values (P = 0.02). The lower (lacrimal) lid punctum distance from the inner canthus preoperatively was 6.5 ± 0.3 mm and 7.4 ± 0.2 on day 1 post operatively, 7.2 ± 0.3 two weeks post operatively, 7.0 ± 0.4 mm at 3 months postoperatively (P = 0.04) [Table 1]. The MRD2 preoperatively was 5.0 ± 0.1 mm, 5.4 ± 0.1 mm at 1 days postoperatively, 5.2 ± 0.2 mm at 2 weeks, and 5.4 ± 0.3 mm at 3 months after surgery (P = 0.02). Conclusions : An increase in lower lid laxity was noted on distraction test & lacrimal lower punctum distance post cataract surgery. Although such a change is expected in the common cataract surgery age group, there seems to be a definite increment noted in the post surgery group.   Keywords: Distraction test, Lacrimal lower punctum, Lid laxity

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Purpose: To compare the results and recurrences of incision and curettage with intralesional triamcinolone acetonide (TA) in treating chalazia. Materials and Methods: Patients with chalazia were treated with either intralesional injection of triamcinolone acetonide or incision and curettage (I & C) by randomisation into 2 different groups. The patients were then followed up after 2 weeks and then 3 months post-procedure to assess the size. A size reduction of 90% was considered as adequately treated for the purposes of this study. Results: Out of a total of 60 patients selected for the study, 30 patients underwent intralesional triamcinolone injections & the other 30 patients incision & curettage for their chalazia respectively. Adequate treatment thresholds were achieved in 24% patients (80%) in the Triamcinolone Acetonide group and 29 patients (96.67%) in the incision & curettage group. Recurrence of the lesion was seen in 9 patients (30%) in the triamcinolone acetonide group & 2 patients (6.67%) in the incision & curettage group. Intraocular pressure & visual acuity remained unaltered during follow-ups in both groups. Conclusions: We found both methods to have good success rates. The I & C group had lesser recurrences and higher success rates when compared to the TA group.   Keywords: Chalazion, Triamcinolone acetonide, Incision & Curettage.

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Introduction: To estimate the efficacy of probing as a treatment option in earliest cases(early catarrhal stage) of epiphora with no discharge due to nasolacrimal duct obstruction. Materials and Methods: An observational clinical study was performed on 25 patients with earliest cases of epiphora with no discharge. Under aseptic precautions along with adequate topical and nasal anaesthesia probing was performed in both upper and lower canaliculi, it was considered successful when epiphora was reduced to a considerable level or had resolved with patent lacrimal system for atleast 6 months after syringing. Results: 14 women and 11 men with age group of 18 to 45 years with complains of epiphora for about 1 year were included in our study. 23 patients had nasolacrimal duct obstruction (NLDO) and 2 patients were post dacrocystorhinostomy (DCR).Complete patency was attained in 23 cases and 2 cases required surgical intervention. Treatment was successful in 92% cases. Conclusion: Probing is simple, safe, cost effective, patient satisfactory, quick and easy day care procedure with low intra and post procedural morbidity. Probing can avoid need of nasolacrimal surgeries and hence can be used as a treatment modality in earliest cases of epiphora with no discharge. Keywords: Nasolacrimal probing, Dacryocystitis in India, Adult dacryocystitis.

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