Mahesh Agarwal

Abstract

Background: COVID-19 pandemic has put all of us in astonishment and concern about its management and survival of human being since there is a great risk of human to human transmission. Teleophthalmology can play a great role to overcome this situation. Earlier teleophthalmology was mainly limited to diagnoistic reachout camps for diabetic eye disease mainly without treatment benefit to the patient. Now with advancement in media technology and availability of good quality smart phones, it is possible to extend scope of teleophthalmlogy for the treatment of superficial ailments of an eye. Our aim of the study was to analyse the eye disease pattern and impact of teleophthalmology on its management in one of the hot centre of India, i.e. Indore, during pandemic period. Materials and Methods: This study is a retrospective, interventional data analysis of patients seen in one month of Lockdown in India, from 26th March to 25th April 2020. All the patients were given teleconsultation with the help of voice calls and still pictures; video call was used wherever it was feasible. In our study, we have divided patients in two groups, first is Tele OSD (Tele Ocular Surface Disorders) where diagnosis on 2D image or video was possible and second group were OED (Other Eye Disease) where in-person consultation was required before making diagnosis or offering treatment. Results: We have done analysis of total 119 patients records who made a call for eye problems between 26th March2020 to 25th April 2020. Out of 119 patients, 107 patients (89.91%) were in Tele OSD and 12 patients (10.08%) were in OED group. Telemedicine was prescribed in 103 patients (103/107, of tele OSD group- 96.26%), of which 102 patients (95.32%) showed marked improvement or are cured on followup. Among the Tele OSD group who received the treatment (103 patients), 79 patients (76.99%) were of conjunctivitis, varying from infectious to allergic origin who responded very well to treatment offered. Conclusion: COVID-19 pandemic has changed the understanding of medical science. Previously telemedicine (more precisely teleophthalmology) used to be a tool for outreach patient diagnosis mainly in rural or suburb area, but now with the advancement of digital media and easy availability of smart phones, it can also be used in the management of common eye diseases, even in urban population. Keywords: Covid 19, Tele ophthalmology, Tele-OSD, Tele consultation, Telemedicine.

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Abstract

Aim: To evaluate the long term outcome of pterygium excision with conjunctival autografting (CAG) using economically viable autologous blood. Materials and Methods: This is a retrospective analysis of total 40 patients who underwent Pterygium excision with CAG using autologous blood as per our inclusion and exclusion criterion. After pterygium excision by avulsion method, we put the 1mm oversized CAG using autologous blood oozing on bare sclera and margins were tucked. Gentle massage for 10 minutes was given. The patients were followed for 48 months to measure the outcome. Results: Our study shows CAG with autologous blood is very effective with zero percent recurrence and retraction of graft. Only in 1 case (2.5%) we have identified gap in graft-host junction as long term complications. This also does not required any intervention as gap was Conclusion : Our study shows long term safety, success of economically viable CAG with autologous blood following pterygium excision. Keywords: Conjunctival auto grafting CAG, Sutureless, Glue less, Autologous blood, Graft host junction gap, Pterygium.

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Abstract

A 24 years old female presented to us with the chief complaint of dimness of vision in her right eye since few days and loss of vision in right eye since childhood. On examination she was having well defined yellow to orange slight elevated lesion at macula and peripapillary area and in the left eye marked depigmentation of macula with subretinal fibrosis. She had undergone Optical coherence tomography (OCT) and Ultrasonography (USG-Bscan) of both the eyes. On the basis of clinical findings and investigation, diagnosis of choroidal osteoma was made. The purpose of reporting this case here is that bilateral choroidal osteoma is a very rare entity and whenever a young female is presenting with this kind of lesion in retina, we should keep the possibility of choroidal osteoma in differential diagnosis. Keywords: Choroidal osteoma, Choroidal tumors, Choroidal neovasular membrane, Antivascular endothelial growth factor.

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