Vaigeye2015 Programme Book Abstracts

Paediatric Ophthalmology & StrabismusFP0000181Safety and efficacy of Botox in paralytic strabismusDr.Muralidhar, Dr.Ramamoorthy, Dr.Vaishnavi MABSTRACT: Aim To evaluate the safety and efficacy of Botox injection in traumatic nerve palsy.METHODS and materials : 11 patients from June 2014-2015 with traumatic sixth nerve palsies of 3 months durationwere treated with injection Botox 2.5 IU to medial rectus.The deviation before and after injection were recorded .Adistance esotropia of less than 10 PD in primary position or absence of diplopia at three months was defined as recovery.RESULTS: The average pre injection deviation was 26.5 PD of esotropia and average post injection deviation was 5PD ofesotropia. Mean angle of esotropia in pre injection group for distance was 29.8+_8.7PD,where as in post injection after 1month was 2.4+_5.1 PD. CONCLUSION: In our series all except one showed complete recovery after three months withoutneed of strabismus surgery and without permanent side effects. However large sample size is required.FP0000177Effect of Park’s Inferior oblique Recession (10 mm) on Ocular TorsionDr. Richa Sharma, Dr. Sandra Ganesh, Dr. Kalpana NarendranABSTRACT: To examine change in ocular torsion after the Inferior oblique weakening procedure ( Park’s recession, 10mm)in patients with primary inferior muscle overaction. METHODS: 24 eyes of 18 patients were included in the study that hadundergone Inferior Oblique recession for grade 2-3 overaction. Fundus photographs were taken to measure torsionaldeviation one day preoperatively, 2 weeks and 4 weeks post operatively. RESULTS: The average torsion decreased from9.65 +/- 6.81 to 5.68 +/- 5.62 with a mean change of 3.95 +/- 2.81 degrees, P value ( < 0.05 ) at 2 weeks ; and to 5.47 +/-5.31 with a mean change of 4.16 +/- 2.94 at 4 weeks (P value < 0.05) . CONCLUSION: About 4 degrees of excyclotorsioncorrection was found in patients with Park’s IO recession.FP0000214Stereopsis test as a screening tool in childrenDr. Nelson Jesudasan c.a., Dr.Antony Arokiadass, Dr.Tanuja BrittoABSTRACT: Aim: To evaluate the use of stereopsis tests as a single tool for detecting vision problems in children.Materials and METHODS: In this double blind study, 200 children, 4 – 12 years, were grouped as those with good (=120 arcsec) or poor (< 120 arc sec) stereopsis.The sensitivity (SN), specificity(SP), positive (PP)& negative(NP) predictive values ofTNO cards, in detecting visual problems were assessed. RESULTS: Of 200 children, 183 (91.2%) children had good & 17 hadpoor stereopsis. Of 183 with good stereopsis, 61(33.3%) had refractive errors(REF) but none had amblyopia or squint; ofthe 17 with poor stereopsis, all had refractive errors, 14 had amblyopia & 4 had squint.TNO cards detected strabismus &amblyopia with high SN &NP value but is less sensitive in detecting REF. CONCLUSION: Stereopsis testing, as a screeningtool, is sensitive for detecting amblyopia & strabismus but not for refractive errors, in children.FP0000212Visual Functions in Refractive ErrorsDr. Lali, Dr. Antony Arokiadass, Dr.Tanuja BrittoABSTRACT: Aim: To study the visual functions in patients with refractive errors (REF) with normal visual acuity(VA)Patients and METHODS: 200 subjects, 10 – 25 years old, with 6/6 VA, were divided into two groups; Gr 1:EmmetropesGr2Ametropes. Best corrected VA, distance & near, contrast sensitivity on LEA 10M symbol chart, colour vision using FMonline 15 hue test, Near point of convergence & accommodation using RAF ruler, Stereopsis using TNO cards, Axial length& Keratometry, reading & writing speed, were done for all patients. RESULTS: analysed using SPSS software. RESULTS:Group 2 had significantly decreased contrast sensitivity, altered colour vision, orthoptic and morphometric parameters(p=0.000), when compared with Group 1.There was a significant correlation between spherical equivalent and visualfunctions (p=0.001). CONCLUSION: Refractive errors are associated with impaired visual functions despite normalcorrected acuity. 99

FP0000242Clinical features of Retinopathy of Prematurity (ROP) in early preterm infantsDr. M. Prathiba, Dr. C.G.Vanila, Dr. A. AnithaABSTRACT: Aim: To describe the clinical features and treatment outcome of ROP among early preterm neonates.Method: Neonates of 27 to 30 W gestational age were periodically screened from 29 to 32 W postconceptional age (PCA).The retinal vascular pattern was documented by indirect ophthalmoscopy. Eyes with worsening abnormal vascularpattern received Laser. Complete regression of ROP features was the outcome measure. RESULTS: 12 of 14 (85%) pretermneonates showed looped and tortuous vessels at the junction of the avascular retina in posterior zone 2. Six who hadcircumferential vessel with worsening plus and the 3of 6 showing additional hybrid features received Laser at 32 to 35W PCA. Rest (50%) showed spontaneous regression. 2 infants had normal vascularisation. CONCLUSION: The occurrenceof ROP in early preterm infants is high and presents with varied features of Aggressive posterior ROP (APROP) requiringtreatment by the third week after birth.The treatment outcome is good.FP/EP0255Functional Outcomes Of Nystagmus SurgeryDr. Vrushali Patil, Dr.Jamuna Krishnakumar, Dr. P. VijayalakshmiABSTRACT: Purpose: To study the surgical outcome in idiopathic infantile nystagmus (IIN). METHODS: 52 patients withIIN were analysed retrospectively over the period of 5 years. Nystagmus evaluation included documentation of headposture, vision in all gazes, associated squint, type -frequency -amplitude & direction of nystagmus. Follow up was doneat 1 day, 1 month postoperatively, 3-6 monthly thereafter. Vision, head posture, ocular alignment & limitation of ocularmovements were documented postoperatively. RESULTS: Surgery for IIN gave full correction of abnormal head posturein 37% & cosmetically acceptable correction in 50-55%. Visual acuity was improved in 54%, while it was same in 46%.CONCLUSION: Surgery for IIN gives satisfactory RESULTS: in terms of improvement in head posture & visual acuity withminimal complications.FP/EP0298Surgical outcome in patients with residual esotropiaDr. Jamuna Krishnakumar, Dr. Vrushali Patil, Dr. Sashikanth ShettyABSTRACT: Aim:To study the outcome of surgery for residual esotropia(ET). METHODS: Patients operated for residualET after primary surgery were analyzed retrospectively. A 2nd surgery was planned after minimum of 6 months;complications, visual outcome ,residual ET were analyzed. RESULTS: 30 patients(mean age 4 years) were analyzed.Thecorrective surgery was performed at a mean duration of 22.2 months. Deviation after 2nd surgery (0-10 PRISM DIOPTERS(PD) OF ET IN 13, 11-20 PD IN 7) & OVER 20 IN 6.15 manifested dissociated vertical deviation(DVD);4 of which were preexisting. After 2nd surgery, 4 had residual esotropia;4-consecutive exotropia of which 1 required prism correction fordiplopia. CONCLUSION: Large angle ET need 2 surgeries for better cosmesis; chances of binoclarity is little. Amount ofresidual ET correction should be a titrated in order to prevent consecutive exotropia.UveaFP0000203Recurrent Anterior Uveitis - could it be TB?Dr.Radhika T, Dr. Lalitha Prajna, Dr. Rathinam Sivakumar, Araviind Eye HospitalABSTRACT: Purpose : To describe anterior segment features of patients with recurrent anterior uveitis, who were resistantto routine treatment and to report the importance of AC Tap PCR as a confirmatory tool for MTB. METHOD: 7 patientswith recurrent anterior uveitis between 2012-2014, were examined by slit lamp and indirect ophthalmoscopy. Allpatients underwent AC tap for PCR TB, besides routine blood test and mantoux. RESULT: 6 of 7 patients had unilateralanterior uveitis. One patient had bilateral anterior uveitis. Non-granulomatous anterior uveitis was seen in 4 patientsand granulomatous anterior uveitis in 3 patients. 5 patients had hypopyon, mantoux was +ve in 2 patients. AC Tapfor PCR was +ve in all 7 patients. All patients were treated with ATT for 6 months with complete resolution of anterioruveitis. CONCLUSION: PCR for MTB of AC fluid is recommended in all patients with Recurrent Anterior Uveitis in a countryendemic for TB.100

FP263Progressive visual and field loss in patients with chronic uveitisDr. Vedhanayaki Rajesh, Dr. Rathinam Sivakumar, Dr. Radhika T, Aravind Eye Hospital,ABSTRACT: Purpose: To evaluate chronic uveitis patients who present with progressive visual and field loss even aftercontrol of their inflammation using anti-inflammatory medications. METHODS: Prospective analysis of 4 patients who fellinto the criteria of progressive visual and field loss in the absence of active inflammation with clinical evaluation, colorvision, visual fields and electroretinogram. RESULTS: These 4 patients had defective color vision ,field defects and ERGchanges (suggestive of rod - cone dystrophy to extinguished ERG) not correlating with the clinical picture.CONCLUSION : There are a group of patients who present with bilateral progressive visual and field loss even after controlof inflammation with steroid and immunosuppressives and with ERG changes consistent with inner retinal pathology.FP/EP0274Clinical Profile and Treatment Outcomes of Choroidal Tubercles in a uveitis clinic in South IndiaDr.Sharanya Abraham, Dr. Sudharshan S, Dr. Jyotirmay Biswas, Sankara NethralayaABSTRACT: Purpose: To study the clinical profile and treatment outcomes of patients with choroidal tubercles METHODS:Retrospective case-series of 10 patients with choroidal tubercles who presented in the year 2014 to a referral eye institutein South India RESULTS: Eighteen eyes of 10 patients were analysed.The mean age of presentation was 46 years andmean follow up was 12.6 months. A systemic diagnosis of tuberculosis and sarcoidosis was made in 5 patients each.Treatment included steroids, immunosuppressants and antitubercular therapy as indicated. All eyes showed resolutionof inflammation.The visual acuity improved in 6 eyes, remained stable in 5 eyes and worsened in 3 eyes. CONCLUSION:Choroidal tubercles have been found in patients with tuberculosis and sarcoidosis. With appropriate treatment,inflammatory lesions resolved in all patients with visual acuity improving or remaining stable in most, providing a basisfor active management in these patients.FP/EP0273Clinical profile, Systemic associations, Treatment and Prognosis of Inflammatory Vascular OcclusionsDr. Meenakshi CT, Dr. Suchitra Pradeep, Sankara NethralayaABSTRACT: Purpose: To analyse the clinical features, systemic associations, treatment of inflammatory vascular occlusions.METHODS: Retrospective case series. RESULTS: Out of 29 eyes of 27 patients, 25 presented with blurred vision, 2 withpain and redness, 4 with floaters. Fundus examination showed branch retinal vein occlusions in 23 eyes, multiple branchretinal vein occlusion in one eye and hemi-retinal vein occlusion in one eye. Diseases associated were Behcet disease in 4,Wegener’s granulomatosis in 3, Ocular tuberculosis in 2,Viral uveitis in 1 and idiopathic in 17 patients.Treatment was withoral steroids in all, 8 with immunosuppressants, 1 each with antiviral and anti-tubercular therapy,16 with laser barrage and2 eyes with intravitreal bevazicumab. Vision improved in 16, remained same in 7 and decreased in 3 eyes. CONCLUSION:It is imperative to suspect inflammation, look for systemic associations and plan appropriate treatment in young patientswith inflammatory occlusions.FP303Study of Ocular manifestations in HIV infected patients at presentation in a tertiary care hospitalDr. Rekha Sravya M, Dr.S.B.Sivathanu, Dr. S.Hari Rama Subramanian, Tirunelveli Medical CollegeABSTRACT: METHOD- Observational, cross sectional, retrospective cohort study of 246 patients who presentedto ophthalmology OP after a positive HIV serology. RESULTS:- Of the patients examined, 71.2% had WHO stageI, 11.4%-II, 13.4%-III, 4%-stage IV infection.Males-65.9%, Females-34.1%.Median age was 31-40 & 51.4% were intheir 4th decade.11.4% patients had ocular manifestations of which post segment pathology-71.4%,ant segmentpathology-28.5%.Of the post segment lesions-HIV retinopathy 70%.Over all it is 5.7%,CMV retinitis 0.8%,others 1.6%.Occupation of pts,labourers-28.9%,drivers-30.4%,CSW-12.1%,others-29.6%. Among those screened,7.7% had CD4count<100/ml,11.3%-<200,28.4%-200-500, 54% ->500 counts. Among those with ocular involvement,53 % had CD4<100,75% <200.CONCLUSIONS-HIV retinopathy is the most common manifestation of HIV infection in this series atpresentation.11.2% presented with ocular manifestations at initial presentation of HIV and 75% of ocular manifestationsare present when CD4 count is <200. 101

FP/EP0349Uveitic manifestations of Hansen’s disease seen in a tertiary eye care hospital in South IndiaDr.John Samuel B, Dr.Sivakumar R Rathinam, Dr.Radhika Thundikandy, Aravind Eye Hospital, MaduraiABSTRACT: Purpose: To describe the uveitic manifestations of Ocular leprosy. METHODS: Retrospective review of casesof ocular leprosy, seen in the Uvea department of our hospital for a period of 4 years (2011-2014. RESULTS: Out of the16 patients who presented with ocular leprosy, we observed that uveitis was a common presentation of which B/LGranulomatous anterior uveitis was noticed in 9 patients (56.25%) with hypopyon in 2 patients, B/L NG anterior uveitiswith scleritis was noticed in 4 patients(25%), Scleritis alone was noticed in 3 patients(18.75%),Conjunctival Leproma wasfound in 1 patient, with HPE proven Lepra bacilli. Further, Iris atrophy with transillumination defects, koeppe & bussacanodules, Lepra pearls was noticed in 3 patients. All patients had madarosis, depressed nasal bridge, Leionine facies,hypopigmented skin patch, thickened nerves, claw hand deformity and past h/o. Leprosy, except for 1 patient who had nosystemic leprosy , except AC tap proven presence of Acid fast Mycobacterium lepraeFP404An Analytical Study on Psoriatic Ocular ManifestationsDr. Krishnaja Mandava K, Dr. S Anandhalakshmi, Dr. Kalpana SureshSri Ramachandra UniversityABSTRACT: AIM: To identify the prevalence of ocular manifestations and to study the frequency and distribution ofpotential sight threatening complications in patients with psoriasis. MATERIALS AND METHODS: This is an analytical,non-interventional, observational study including one hundred and five patients diagnosed with psoriasis. Detailedhistory and comprehensive eye examination was done including dry eye work up. RESULTS: Our study showed maledominance of 57% and females of 47% of population. Maximun number of patients were in age group of 40-60years.Inour study most common ocular manifestation was Blepharitis seen in 23% and conjunctivitis seen in 25% of population.In our study population only 3% patients had chronic uveitis.The number patients with evaporative dry eye was 28%.CONCLUSION : Multi-disciplinary approach including effective screening and early detection of ocular manifestationsfollowed by prompt treatment is required to reduce the morbidity of the patients with psoriasis.102