Piyali Sarkar

Objective: To find out the correlation of Meibomian gland and Tear film dysfunction with pterygium. Design: Institution based prospective cross sectional study. Materials and Methods: 70 (seventy) patients with unilateral primary progressive nasal Pterygium and 70 healthy adults without any ocular pathology were selected as comparison group from the Ophthalmology outpatient department of Calcutta National Medical College and hospital, Kolkata for a duration of 6 months from January 2020 to June 2020. Meibomian gland dysfunction was measured by meibomian gland expression score and lid margin abnormality score. Tear film changes were measured by Ocular Surface Disease Index (OSDI) Score , Tear break up time (TBUT), Tear meniscus height(TMH), Schirmer’s test 1 (ST1) and Corneal flourescein staining in both pterygium and control group and comparisons were done to find out the significance in differences. Statistical Analysis: The Categorical variables were analyzed with the help of Pearson Chi square test, Spearman rho Correlation, Man Whitney U Test and the continuous variables were analyzed with the help of Independent T test and Pearson Correlation coefficient. The level of significance was considered as 95% of confidence interval i.e. P value Results: OSDI score, TBUT, meibomian gland expression score, lid margin abnormality score and corneal fluoresce in staining were significantly higher in pterygium group than others (p Conclusion: Meibomian gland function was altered in patient with Pterygium which is also associated with uncomfortable ocular symptoms due to tear film abnormalities.   Keywords: Pterygium, Meibomian Gland Dysfunction, Tear Film

Background: Inflammation of the cornea is known as keratitis. Microbial keratitis is a great challenge for the physicians due to its varied presentation, overlapping symptoms and rapid progression. Though bacterial keratitis is the most prevalent in developing countries but recent increasing trend of fungal keratitis carries a significant risk factors and one of the leading causes of vision loss. Early diagnosis and treatment are the cornerstone for its effective control. Purpose: To determine the outcome and efficacy of treatment with topical natamycin and topical voriconazole in different groups. Materials and Methods: It was a randomised, prospective, comparative, experimental study. The study populations were selected according to inclusion and exclusion criteria after proper evaluation. The study populations were divided into Group A (treated with 1% topical natamycin) and group B (treated 5% topical voriconazole. The patients were followed up subsequently. Data were collected, tabulated in Excel sheet and analyzed in percentage, proportion, t-test and chi square (?2) test. The statistically significant was considered if p value Result: The average age of the study populations was 39.32 ± 14.99 years. Topical voriconazole was found better against primary fungal ulcer than natamycin but not statistically significant (?2=0.283, p=0.59). The mean healing times of group A and group B were 25.42 ± 4.59 and 24.92 ± 3.99 days respectively. Conclusions: This study concluded that it had male predominance, commonly involved younger people and poor socioeconomic agricultural workers. Both drugs were found effective against primary ulcer but voriconazole was slightly better.   Keywords: Corneal ulcer, Fungal keratitis, Natamycin and

Background: Cataract surgery now a days has become a refractive surgery. It not only improves the vision, but also provides good unaided visual acuity(VA). Sutureless small incision cataract surgery(SICS) induces minimum astigmatism. It also helps in early rehabilitation by faster stabilisation of post-operative refraction. Objective: The aim of this prospective observational study was to compare the Surgery induced astigmatism(SIA) and VA following manual SICS with superior and temporal incisions. Materials and Methods: Consecutive 100 patients in the age group of 40 -70 years with cataract having VA underwent manual SICS with superior scleral incision and rest 50 with temporal incision. Post operative astigmatism was measured at 4th and 8th weeks. Best corrected VA was checked at 8th week. SIA was calculated at 4th and 8th week post operatively. The statistical analysis was done with the help of SPSS 18 statistical analysis software, measuring p value, mean and standard deviation. Results: The mean SIA in superior and temporal SICS at 4rth week was 1.06+/-0.41 DCyl and 0.75+/-0.36 DCyl respectively (p=0.000) and at 8thweek was 0.99+/-0.31 DCyl and 0.64+/- 0.32 DCyl respectively (p=0.000). The difference of SIA at 4rth and 8th week in both the techniques was statistically insignificant.41 patients with superior incision and 43 patients with temporal incision had VA of 6/6 at 8th post operative week.VA was 6/9 in 6 patients with superior incision and 3 patients with temporal incision. Whereas, VA was 6/12 in 3 patients with superior incision and 4 patients with temporal incision at 8th post operative week.VA at 8th post-operative week in both the techniques were comparable. Conclusion: SIA in temporal SICS is significantly lesser than that in superior SICS whereas VA in both the techniques is excellent and comparable. Keywords: SICS, SIA, Incision site.

Purpose: The study was conducted to find out the topographic changes of disc, macular thickness, visual field, and intra-ocular pressure (IOP) after trabeculectomy in different age and sex using Optical Coherence Tomography (OCT) machine, automated perimeter and Goldman applanation tonometer respectively. Materials and Methods: It was a prospective, interventional case-series conducted at the glaucoma clinic at Regional Institute of Ophthalmology, Kolkata from March 2010 to August 2011. Patients of primary open angle glaucoma who fulfilled the inclusion criteria. The trabeculectomy surgeries were done by a single surgeon. The disc changes, macular thickness, IOP and visual field changes were measured before and after trabeculectomy. Preoperative OCT images of disc and macula, visual field testing by Humphrey automated perimeter and IOP by Goldman applanation tonometry were done/within 3 months prior to surgery and same investigations had been done postoperatively within 2 to 3 months after surgery. Data was collected in a standard data collection form and analysis was done by paired t-test. Results: Significant visual field (mean deviation-MD & pattern standard deviation-PSD in decibel) changes were seen but the nerve fiber thickness in the disc and macula were not increased. Significant reduction of IOP was found after trabeculectomy. Conclusions: Significant visual field (MD& PSD) changes were found after trabeculectomy in early glaucoma patients but disc and macular changes were found to be insignificant. Keywords: Automated perimetry, Optical Coherence Tomography, (OCT), Primary open angle glaucoma.

Introduction: Lens Induced Glaucoma (LIG) is one of commonest cause of secondary glaucoma due to senile cataracts. The purpose of this study was to assess the outcome of LIG following cataract surgery. Objective: To determine the frequency, types, the clinical presentations, management and outcome of lens-induced glaucoma (LIG). Materials and Methods: It was a prospective observational study which was done at Calcutta National Medical College, Kolkata, from July 2012 to June 2013. Patients who attended out-patient department (OPD) of this hospital with LIG were admitted for conservative management followed by cataract surgery. Demographic data, clinical presentations, management and outcome were recorded and analysed. Results: The age of presentation of LIG was varied ranging from 31 years to 85 years. The study had female preponderance (53.7%). The major type of LIG was phacolytic glaucoma (53.8%). All the patients had pain and watering in the eyes and decreased vision during admission. Most patients (31 eyes) were presented with visual acuity of hand movements (57.4%) and intraocular pressure more than 40 mm Hg (61.1%). Most of the patients (75.9%) underwent manual small incision cataract surgery (M-SICS) with posterior chamber lens (PCIOL) implantation. Reduced Intraocular pressure (IOP) after complete follow up was 15.2 mm Hg and most of the patients (75.9%) had their post-operative best corrected visual acuity more than 6/36 after completed follow up. Conclusion: Cataract surgery was the most important effective mode of lowering IOP and visual recovery in patients with lens induced glaucoma. Public awareness and early detection by house physician is important for an early intervention which aids IOP control and visual recovery in LIG. Keywords: Lens-induced glaucoma, Phacomorphic glaucoma, Phacolytic glaucoma.

Background: Diabetic retinopathy is a common microvascular complication of diabetes mellitus and one of the leading causes of acquired blindness. Microalbuminuria reflects a pathophysiological state of vascular dysfunction and organ damage. It is noticed that a rise in urinary albumin excretion is seen in the early phase of diabetic retinopathy. The concordance of microalbuminuria and diabetic retinopathy has been well reported in type 1 diabetes; however, for type 2 diabetes, there is a paucity of data. Objective: To estimate the prevalence of microalbuminuria in diabetic retinopathy patients with type 2 diabetes attending the out-patient department (OPD) in a tertiary care center in eastern India and also to find out any association between microalbuminuria and severity of diabetic retinopathy. Material and Methods : The study included 200 patients with type 2 diabetic patients having diabetic retinopathy. The study populations were selected by thorough clinical examination and as per inclusion–exclusion criteria. Estimation of urinary albumin and albumin creatinine ratio was done by using Konelab 20 Autoanalyzer machine by the immunoturbidimetry method. Diabetic retinopathy was classified as per the International Clinical Diabetic Retinopathy Severity Scales into mild, moderate, severe, very severe non-proliferative as well as proliferative diabetic retinopathy. Data were analyzed with ratio, rate, percentage, and statistical significance was considered if p Results: The prevalence of microalbuminuria was found in 36% (72 patients). The highest number of patients (88.24%) with microalbuminuria was found in severe NPDR. 93.06% of patients with microalbuminuria had clinically significant macular edema. A statistically significant correlation (p Conclusion: A significant correlation was found between urinary microalbumin and the severity of diabetic retinopathy.   Keywords: Diabetic retinopathy, Microalbuminuria, Type 2 diabetes mellitus.