To compare the obtainability and values of IOP measurements by Goldmann Applanation Tonometry (GAT) and Ocular Response Analyzer (ORA) before and after penetrating keratoplasty (PKP) testing the degree of their agreement and the impact of corneal biomechanical factors on IOP measurement. Patients and Methods: The study is a comparative prospective study in which patients scheduled for penetrating keratoplasty (PKP) undergo intraocular pressure measurement (IOP) using the Ocular Response Analyzer (ORA) then the Goldman applanation tonometer (GAT) one day before surgery to be repeated one month after their surgery. Results: Forty patients undergoing PKP were enrolled in the study, 28 males (70%) and 12 females (30%). The mean age of patients involved is 42.8 ± 15.4, ranging between 9 and 75 years. Obtainability of ORA (92.5% of the patients) was significantly higher than GAT (60%) postoperatively (p<0.001), while no significant difference was elicited preoperatively. The mean cornea corrected IOP (IOPcc) was significantly higher than GAT and Goldmann related IOP (IOPg) both pre and postoperatively. In addition, both mean IOPcc and GAT postoperatively (19.2 ± 8.31, 15.65 ± 6.99 mmhg respectively) were significantly higher than their preoperative values (14.44 ± 7.03, 11.78 ± 4.55 mmhg respectively). Strong correlations existed between GAT and ORA measurements both pre and postoperatively. The level of agreement between GAT and IOPg was higher than IOPcc. Conclusion: ORA has proven to be superior to GAT in the ability to obtain reliable IOP measurements post PKP. IOPcc measurements also prooved to be relavant, independent on corneal biomechanical factors (CH and CRF) but judging the accuracy of its values needs further large scale studies.  

Age-related macular degeneration is one of the primary causes of blindness in the United States as well as worldwide. The purpose of the present in vitro study was to test the hypothesis that natural compounds will rescue RPE cells from AMD mitochondria-induced damage, thereby rescuing AMD retinal cells. Our long-term goal is to develop a personalized treatment strategy for AMD patients. Herein, we treated AMD RPE transmitochondrial cells with naturally occurring antioxidants and neuroprotective compounds that are available as over-the-counter medications. AMD RPE transmitochondrial cells had identical nuclei but differed in mitochondrial DNA (mtDNA) content. Cell survival, free radical production, oxidative stress, and mitochondrial health was examined and compared between untreated AMD cells and the AMD cells treated with natural compounds. Treatment with natural compounds improved cell survival and mitochondrial health, reduced free radicals and oxidative stress, mitigated cell death, and increased live cell number in AMD cells compared to their untreated counterparts (p<0.05). In conclusion, the natural compounds used in this study might serve as effective, inexpensive, and non-invasive therapeutic options and might help in the development of a personalized treatment strategy for AMD patients.

Some Retinitis Pigmentosa (RP) subjects show improved visual function following Transcorneal Electrical Stimulation (TES). (1, 3) The present study is a longitudinal report of the three subjects who were monitored > 41 months for declining visual function, which is expected in those with RP. The subjects received periodic retreatments of TES.  Over a period of 41-43 months we monitored visual acuity (VA), quick contrast sensitivity function (qCSF) and visual acuity (VA).  We found improvement in some of the functions for all three participants and did not see a drop below initial baseline in any of the subjects. Patient reports were consistent with the objective findings of enhanced visual performance. After encouraging visual improvements post TES that lasted several months, it appears restoration and/or prevention of slowly diminishing vision (or, at least maintenance of baseline findings) over time is possible with continued retreatments of TES.  This requires large scale controlled study confirmation.

Measurement is the basis of scientific work and is done in a variety of ways. It is easy and accurate in physical sciences but not so in life sciences like medical science. A   disease can be defined as a variable quantum of structural and or functional loss. Since the expression of these are very variable one can approximately convert the structural and functional loses in percentage and add them to get total loss. A method has been developed to do the same by making a traumagram on a graph paper. A horizontal straight line of 20 cm is drawn at the bottom of graph paper. From its centre a vertical 10 cm line is drawn which indicates the time period in weeks. Recording is started from the bottom line. On the left side structural loss is recorded and the functional loss on the right side by a point. This is recorded at weekly interval. Usually we a get a slanting line on either side. After 8-10 weeks the upper ends of both the lines are joined. This results in roughly a quadrangle figure which is termed traumagram. The mm squares enclosed in traumagram are counted and each is expressed as one trauma unit (1.T.U.). The total number of units indicate the magnitude of loss.

Multiple Sclerosis (MS) is a demyelinating disease of the central nervous system leading to disability, especially in young patients. Acute or chronic lesions of MS within the brainstem and the cerebellum frequently results in ocular motor diseases. Eye movement disorders have the potential of being utilised as structural and functional biomarkers of early cognitive deficit and possibly help in assessing disease status and progression. Early detection of gaze palsies aids in diagnosis of various demyelinating conditions. This is also an important aspect of follow up examination as relapse, chronicity can be diagnosed with careful examination of gaze movements. The proper identification of voluntary gaze abnormality on clinical examination allows to map out site of demyelination and make neuroimaging precise and easier.

Age-related macular degeneration is one of the primary causes of blindness in the United States as well as worldwide. The purpose of the present in vitro study was to test the hypothesis that natural compounds will rescue RPE cells from AMD mitochondria-induced damage, thereby rescuing AMD retinal cells. Our long-term goal is to develop a personalized treatment strategy for AMD patients. Herein, we treated AMD RPE transmitochondrial cells with naturally occurring antioxidants and neuroprotective compounds that are available as over-the-counter medications. AMD RPE transmitochondrial cells had identical nuclei but differed in mitochondrial DNA (mtDNA) content. Cell survival, free radical production, oxidative stress, and mitochondrial health was examined and compared between untreated AMD cells and the AMD cells treated with natural compounds. Treatment with natural compounds improved cell survival and mitochondrial health, reduced free radicals and oxidative stress, mitigated cell death, and increased live cell number in AMD cells compared to their untreated counterparts (p<0.05). In conclusion, the natural compounds used in this study might serve as effective, inexpensive, and non-invasive therapeutic options and might help in the development of a personalized treatment strategy for AMD patients.

The purpose is to study the structural outcome of intravitreal injections of Ranibizumab in zone 2 stage 3 ROP. Premature infants born in CHU-Mustapha maternity hospital, who met our main screening criteria, (Infants born before 30weeks gestational age and/or weighing less than 1500g at birth and/or required any sort of ventilation assistance and oxygen therapy) were automatically sent for screening following discharge. All screenings were carried out using a Retcam 3, after pupil dilation, using both tropicamide and phenylephrine, on awake infants. stage 3 zone 2 ROP were treated in the operating theatre under strict aseptic conditions with a single injection of 0.20mg Ranibizumab. Follow up exams were also carried out using a Retcam 3, after pupil dilation, on awake infants, 48 hours, days 7, 14, 21, and 28 as well as every second week for 3 months and every month for six months or until completion of retinal vascularisation.

To compare the obtainability and values of IOP measurements by Goldmann Applanation Tonometry (GAT) and Ocular Response Analyzer (ORA) before and after penetrating keratoplasty (PKP) testing the degree of their agreement and the impact of corneal biomechanical factors on IOP measurement. Patients and Methods: The study is a comparative prospective study in which patients scheduled for penetrating keratoplasty (PKP) undergo intraocular pressure measurement (IOP) using the Ocular Response Analyzer (ORA) then the Goldman applanation tonometer (GAT) one day before surgery to be repeated one month after their surgery. Results: Forty patients undergoing PKP were enrolled in the study, 28 males (70%) and 12 females (30%). The mean age of patients involved is 42.8 ± 15.4, ranging between 9 and 75 years. Obtainability of ORA (92.5% of the patients) was significantly higher than GAT (60%) postoperatively (p<0.001), while no significant difference was elicited preoperatively. The mean cornea corrected IOP (IOPcc) was significantly higher than GAT and Goldmann related IOP (IOPg) both pre and postoperatively. In addition, both mean IOPcc and GAT postoperatively (19.2 ± 8.31, 15.65 ± 6.99 mmhg respectively) were significantly higher than their preoperative values (14.44 ± 7.03, 11.78 ± 4.55 mmhg respectively). Strong correlations existed between GAT and ORA measurements both pre and postoperatively. The level of agreement between GAT and IOPg was higher than IOPcc. Conclusion: ORA has proven to be superior to GAT in the ability to obtain reliable IOP measurements post PKP. IOPcc measurements also prooved to be relavant, independent on corneal biomechanical factors (CH and CRF) but judging the accuracy of its values needs further large scale studies.  

Graft-versus-host disease (GvHD) is a common complication of allogenic hematological stem cell transplantations that is often associated with dry eye disease (DED) with mixed Meibomian gland dysfunction and aqueous tear deficiency. The temperature-dependence of conformational changes in human meibum (hM) was measured in a comparative study to elucidate the potential impact of GvHD on hM composition, structure and function with DED. A total of 28 donors without DED and 15 donors with DED separated into adolescent and adult pools, were analyzed by Fourier Transform Infrared Spectroscopy. Both age and DED lead to conformational and thermodynamic differences in hM. Increases in lipid order and transition temperatures were observed in hM with GvHD. However, these relative increases were more pronounced in hM from adolescents than from adults. The decrease of change in enthalpy for adolescents was more pronounced compared with adults. The conformational and thermodynamic differences observed with age and, importantly, with DED/GvHD are indicative of compositional changes in hM that could impact tear film stability. We decided to test this theory. We hypothesize that the hM layer alone or hM layer interacting with phospholipids (PLs) in the aqueous portion of tears act as a barrier to tear evaporation; and that in patients with DED/GvHD, either altered composition of the hM and/or its interaction with PLs in tears, lead to a greater rate of evaporative fluid loss from tears. Our studies suggest that the hM alone does not retard the evaporation of water from a saline solution used as an aqueous phase.

History of innovation, progressive of power causes fixed distance object visual strain because of inability to fix the visual gaze for longer periods. 10020 patients were studied in a period of 2 years and the results are all patients of fixed distant object viewers were unhappy with progressive lenses because of inability to fix visual gaze for longer periods. Conclusion is more than 1 dioptre addition advisable to take bifocals. Computer operators advisable to take near vision glasses with less of +0.25d.

Article (226) high court & article (32) supreme court – Indian penal code-applicable to all specialties. International court of justice only deals with land disputes. So, this presentation is needed to arrest further spread to younger generation.AIOS is second largest society in the world registered under society Act in the constitution of India. Are we justified in learning and also teaching knowingly non-precise / incorrect medical terms to younger generation without even mentioning misnomers and in turn making them habituated? Under article 226 (high court) & 32 (Supreme Court) in the Constitution of India-Grievance. Our solution is to change or to teach misnomer along with the word.  For the past 10 years, the same concept was being projected to the world as ‘Questionable medical terms in Ophthalmology’. As some of our AIOS governing council (2013-14) defended as lack of law and not authorized to opine on, retired judge was being consulted and the title is changed with law details as ‘Grievance in literature Ophthalmology-our solutions’.Retrospective study of ophthalmic literature shows for the last more than hundred years, incorrect medical terms like ‘retinoscopy’, ‘syringing’, ‘retinal detachment’, ‘intracapsular cataract’ have been in existence. Phaco emulsification came approximately 28 years ago, 10 years ago small incision cataract surgery and 5 years ago computer vision syndrome. These less precise terms are being added to the medical literature during our own generation. No attempt has been made in the past even with appeal to restore precision and greater accuracy to the terminology in current use. Perhaps none took cognizance of the problem or the need for such correction was not taken seriously. It is unethical that evidence based incorrect medical terms are being published in all scientific journals. Even with appeal, knowingly publishing incorrect medical terms in scientific journals and passing on to innocent younger generation is grievance. At present evidence based science is kept on the desk of chairman, ethics committee, international council of ophthalmology for consideration after relooking. Law is applied to all sciences. Ophthalmology is the starter of the procedure. Global parliament in Ophthalmology is needed in this concern. Search you tube: Ophthalmic visionary to all disciplines and Google search grievance in teaching ophthalmology.

Hot orbit is a term applied to a group of orbital disorders presented with the cardinal manifestations of inflammations as pain, redness, hotness and impaired ocular motility. This group of orbital disorders which varies from trivial as orbital hematoma to a very sever life and sometimes life threatening disorders as orbital metastasis and fungal orbital infections. In this study we describe our protocol in Tanta University Hospital Ophthalmology department, Egypt, for how to manage a case of hot orbit. In this study we present a tentative novel classification of hot orbit basically into infectious, non-infectious and mascaraed groups.