bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving assistive technology access to students with low vision and blindness in Delhi: A school-based model
Authors: Senjam Suraj Singh , Manna Souvik , Vashist Praveen , Gupta Vivek , Grover Sumit , Kumar Vikas Ajeet , Titiyal Jeewan Singh
Published: January 2023

Purpose:

Assistive technology (AT) has recently received considerable attention around the world. Studies have shown poor access to assistive technology for visual impairment (ATVI) in schools for the blind in India. The present article aimed at designing a school-based model to improve AT access in schools and provide hands-on training, and identify types of ocular morbidities present among students.

Methods:

The vision rehabilitation (VR) team of a tertiary eye-care center visited schools for the blind as a part of community-based VR services. The team conducted a basic eye examination and assessed best-corrected vision acuity (BCVA) and provided VR services. Furthermore, two schools were selected to establish an ATVI learning center as a pilot model.

Results:

In total, 1887 students were registered for VR and obtained their disability certificates in 2019-20. Retina problems (25.7%), globe abnormalities (25.5%), optic nerve atrophy (13.6%), and squint (12.0%) were common ocular problems identified in students. Around 50.3% of students had BCVA ³ 1/60 in the better eye who would be benefited from visual-based AT, and the remaining students with visual substitution AT. Further, 20.8% of them who had near vision between N18 to N24 would be benefitted from large print books. Two schools were provided ATVI with support from the WHO. Familiarization, demonstration, and initial training for ATVI were carried out.

Conclusion:

A sizable number of the students would be benefitted from visual-based AT apart from visual substitutions AT. Students were interested to have such ATVI centers in the school for academic and non-academic skills development.
Novel optical coherence tomography angiography biomarkers in the diagnosis and assessment of diabetic macular edema and diabetic macular ischemia in patients with non-proliferative diabetic retinopathy
Authors: Thaker Shivna , Kumar Vinod , Singh Upasna , Kumar Santosh
Published: January 2023

Purpose:

The present study aims to determine the macular and choroidal optical coherence tomography angiography (OCTA) biomarkers in the assessment and monitoring of diabetic macular edema (DME) and diabetic macular ischemia (DMI) in patients with non-proliferative diabetic retinopathy (NPDR).

Methods:

In this cohort study, a total of 176 eyes of 110 patients with NPDR were investigated at our institute over a period of 10 months. Eyes were divided into four groups based on the severity of NPDR. Each eye was subjected to OCTA (Topcon 3D OCT-1 Maestro2) macula 6 × 6 mm2 en face. It features IMAGEnet 6 software for dynamic viewing of OCTA and imaging data. Four OCTA biomarkers for the macula were identified: foveal avascular zone area (FAZ area), foveal avascular zone contour irregularity (FAZ-CI), capillary dropout areas (CDA), and perifoveal intercapillary areas (PICA). The choroidal OCTA biomarker was the number of choroidal circulation flow voids (CCFV). For all analyses, P < 0.05 was considered statistically significant.

Results:

Increase in FAZ area and number of CDA were statistically significant (p < 0.0001) with an increase in central foveal thickness, suggesting a correlation of ischemic changes with an increase in DME. FAZ-CI, enlarged PICA, and CCFV were significantly associated with more severe NPDR patients.

Conclusion:

A correlation between DME and DMI in a patient of NPDR and its progression can be evaluated in a single visit. A unique feature of our study is it revealed novel diagnostic biomarkers of OCTA for DMI and DME.
Clinical profile and management of granulomatosis with polyangiitis–associated scleritis from a tertiary care hospital in South India
Authors: Mohanan-Earatt Amanda , Biswas Jyotirmay
Published: January 2023

Purpose:

To describe the clinical features and management of patients with scleritis associated with granulomatosis with polyangiitis (GPA) at a tertiary eye care center in South India.

Methods:

The clinical profile and management of patients presenting to a tertiary eye care center in South India with scleritis secondary to GPA from 2003 to 2021 were analyzed retrospectively. Scleritis was classified into anterior diffuse, nodular, and necrotizing scleritis with inflammation according to Watson and Hayreh’s classification. Demographic characteristics, clinical features, anti-neutrophil cytoplasmic antibody (ANCA) positivity, treatment response, ocular complications, and status at the last follow-up were analyzed. Statistical analysis of data was performed using Microsoft Excel 2019.

Results:

Nineteen eyes of 17 patients (15 cytoplasmic staining ANCA [c-ANCA], two p-ANCA positive) were included. Fifteen eyes had necrotizing scleritis, two had diffuse anterior scleritis, and two had nodular scleritis. Remission was induced using a combination of steroids and cyclophosphamide or rituximab. Maintenance therapy was instituted using tapering steroids and immunosuppressants like cyclophosphamide, mycophenolate mofetil, methotrexate, or rituximab. Three eyes required a scleral patch graft. Fourteen patients had good anatomical and visual outcomes, and three were lost to follow-up.

Conclusion:

GPA is a rare disease, while it is the most common ANCA-associated vasculitis with scleritis. As scleritis may be the presenting sign of the disease, ophthalmologists must be aware of the various features suggestive of GPA. GPA-associated scleritis can have a good prognosis when diagnosed promptly and managed aggressively in the acute stage, and remission is maintained with adequate systemic immunosuppression.
Effect of pupil dilation on biometric iris recognition systems for personal authentication
Authors: Singh Tanushree , Zaka-Ur-Rab Simi , Arrin Shazia
Published: January 2023

Purpose:

To study the effect of pupil dilation on a biometric iris recognition (BIR) system for personal authentication and identification.

Methods:

A prospective, non-randomized, single-center cohort study was conducted on patients who reported for a routine eye check-up from November 2017 to November 2019 (2 years). An iris scanning device “IRITECH-MK2120U” was used to initially enroll the undilated eyes. Baseline scans were taken after matching with the enrolled database. All eyes were topically dilated and matched again with the enrolled database. The Hamming distance (a measure of disagreement between two iris codes) and recognition status were recorded from the device output, and eyes were evaluated by slit-lamp ophthalmoscopy with special emphasis on pupil shape, size, and texture.

Results:

All 321 enrolled eyes matched after topical dilation. The pupil size had a significant effect on Hamming distance with a P value <0.05. There were no false matches. A correct recognition rate of 100% was obtained after dilation. No loss of iris texture or pupil shape was observed after dilation.

Conclusion:

A BIR system is a reliable method for identification and personal authentication after pupil dilation. Topically dilated pupils are not a cause for non-recognition of iris scans.
Conjunctival collagen crosslinking for the management of bleb leak
Authors: Lázaro-Rodríguez Víctor , Casado-López Daniel , Tolosa Francisco Ruiz
Published: January 2023

The purpose of this article is to evaluate the effectiveness of collagen crosslinking of filtering blebs with 0.1% riboflavin stimulated with ultraviolet A radiation in a case of a thin-walled filtering bleb with leakage following an episode of late blebitis. The time to cessation of the bleb leakage was studied, as well as the intraocular pressure, the visual acuity, and the presence of adverse effects during 4 years of follow-up after treatment. A single session of crosslinking was effective in resolving the leakage of the filtering bleb. There were no adverse effects. The intraocular pressure and the visual acuity remained stable after 4 years of follow-up. Collagen crosslinking with 0.1% riboflavin stimulated with ultraviolet A radiation may prove to be a simple, painless, non-invasive, and repeatable treatment of the leaking bleb with the aim of strengthening the collagen fibers of the conjunctiva and avoiding more invasive surgical treatments.
Smartphone co-aided cobalt blue anterior segment with intraocular lens photography
Authors: Chandrakanth Prithvi , Verghese Shishir , Shiroya Pinkal , Khan Aiman A , Gosalia Hirika , Revathi R , Narendran Venkatapathy
Published: January 2023

In this report, we have utilized a smartphone-based innovative tool named anterior segment photography with an intraocular lens (ASPI) with a cobalt blue filter on the smartphone flash for photographing fluorescein-stained corneas. An intraocular lens along with a cobalt blue filter was attached to the smartphone camera to achieve this purpose. The filter could block out all wavelengths of light except the blue wavelength (450–490 nm) emerging from the smartphone camera. A pilot study was conducted on 27 eyes of 25 patients where images of various corneal pathologies were obtained using ASPI blue light imaging. The images were clear and highly magnified and could be used for documentation, teleconsultation for expert opinion, education, and monitoring of disease progression. ASPI-aided blue light imaging could be easily fabricated and is a frugal inexpensive device, which is used by different ophthalmic personnel to obtain fluorescein-stained corneal images.
Corneal manifestations and treatment among patients with COVID-19-associated rhino-orbito-cerebral mucormycosis
Authors: Yadav Rekha , Madan Siddharth , Rohatgi Jolly , Sahu Pramod Kumar , Das Shukla , Tandon Anupama , Rai Puja , Verma Priya , Singh Jubin , Bajaj Ishita
Published: January 2023

Purpose:

TO report the corneal manifestations in patients with COVID-19-associated rhino-orbito-cerebral mucormycosis (ROCM).

Methods:

This study was a retrospective, observational, and record-based analysis of patients of ROCM with corneal involvement.

Results:

A total of 220 patients were diagnosed with ROCM over a period of 3 months. Thirty-two patients had developed corneal manifestations. The mean age at diagnosis was 52.84 ± 12.8 years. The associated risk factors were systemic mucormycosis, uncontrolled diabetes, recent COVID-19 infection, and injudicious use of systemic steroids. Twenty-nine patients were known diabetics, 32 had recent COVID-19 infection, and 13 gave a history of injudicious use of steroids. The right eye (RE) was affected in nine patients, the left eye (LE) in 20 patients, and both eyes in three patients. Nine patients had a round-oval corneal ulcer. One patient each had a perforated corneal ulcer with uveal prolapse, sealed perforated corneal ulcer, spontaneously healed limbal perforation, diffuse corneal haze with hyphemia, panophthalmitis, diffuse corneal stromal abscess, limbal ischemia, anterior uveitis with posterior synechiae, inferior corneal facet, and filamentary keratitis. Three patients each had a corneal melt and inferior conjunctival xerosis with chemosis. Orbital exenteration was performed in six patients. Five patients with corneal ulcers healed. Topical eye drops of amphotericin (0.5 mg/ml) cycloplegic, antiglaucoma medications, and lubricant eye drops were started along with systemic antifungals.

Conclusion:

Central corneal ulcer was the most common manifestation of mucormycosis. A concentration as low as 0.5 mg/ml of amphotericin eye drops was effective in the treatment.
Ocular morbidity and co-morbidities in children attending a nodal district early intervention center in Uttar Pradesh
Authors: Masood Anam , Amitava Abadan K , Khalid Anam , Firdaus Uzma , Gupta Yogesh , Raza S Aisha , Bose Aparna
Published: January 2023

Purpose:

To obtain epidemiological data on children with ocular morbidity attending a nodal district early intervention center (DEIC).

Methods:

After parental consent, we recruited children with ocular morbidity. After detailed history and clinical evaluation, along with pediatric consultation and relevant neuro-radiological and ancillary investigation, information was entered in a pretested proforma: especially looking for perinatal morbidity, including developmental delay (DD). Visual acuity (VA) was assessed by age-appropriate means by an ophthalmic assistant trained to work with children with special needs. We diligently looked for strabismus and performed dilated ophthalmoscopy. Using JASP, we summarized data as means and proportions and reported 95% CIs. We explored the association of disability percentage with possible predictor variables using regression.

Results:

We enrolled 320 children, with a mean age of 34.43 ± 31.35 months; two-thirds were male; one-third belonged to lower socioeconomic status (36%), with most parents being illiterate. The mean presenting VA was 1.8 logMAR for both eyes, range: 0 to 3. Sixty-one percent were hyperopic and 27% were myopic. High refractive error, (>±6D) occurred in nine; anisometropia in one; strabismus in 149, mostly esotropia; congenital cataract in 25, whereas 63 had abnormal fundus. Seventy-six received a diagnosis of cerebral visual impairment (CVI). On multivariate linear regression (MLR), younger age, presence of DD, and CVI significantly predicted a higher disability percentage. Logistic regression revealed that statutory disability is likely associated with DD (odds ratio [OR]: 13.43); whereas older age was protective (OR: 0.977).

Conclusion:

Our study suggests that in DEIC children with ocular morbidity, younger children, and the presence of DD significantly predict both greater disability and the likelihood of statutory levels.
A cross-sectional study to describe the spectrum of ocular manifestations and risk factors of mucormycosis presenting to a tertiary hospital of East India
Authors: Raj Amit , Nishant Prateek , Sadhukhan Kaushik , Saha Bhawesh C , Sinha Upasna , Kokkayil Prathyusha , Gupta Abhishek , Kumar Amit , Tiwari Pragati
Published: January 2023

Purpose:

To report the clinico-demographic profile of rhino-orbito-cerebral mucormycosis (ROCM) in patients during the “second wave” of the COVID-19 pandemic in eastern India, and their ophthalmic manifestations at presentation to our tertiary institute.

Methods:

Cross-sectional study amongst patients presenting to our center based on their hospital records. Demographic information, history related to COVID-19, records of detailed ocular examination, and microbiological, radiological, and histopathological investigation were entered into an online worksheet and analyzed using SPSS 26.0.

Results:

A total of 219 patients with ROCM were treated from May to September 2021, and 110 of these had ocular manifestations at presentation (50.2%). The age of patients ranged from 22 to 83 years and the mean ± standard deviation (SD) age was 49.9 ± 12.9 years. Ninety (81.8%) patients had been diagnosed with diabetes mellitus, 31 (34%) had hypertension, and 10 had other comorbidities. The duration between the onset of COVID-19 and mucormycosis symptoms was 0 to 60 days with a mean ± SD interval of 20.9 ± 12.6 days. Fifty-six (50.9%) patients had a history of steroid use. Unrelenting ocular or facial pain was the most common presenting symptom, ptosis was the most common anterior segment manifestation, and ophthalmic artery occlusion was the most common posterior segment manifestation.

Conclusion:

Our data from eastern India reinforces the relationship between COVID-19, diabetes, corticosteroid use, and ROCM. Knowledge of various presenting anterior and posterior segment manifestations of the disease as described in the present study will guide clinicians to recognize the disease early and make every effort to prevent complications.
Identification of potential barriers for timely access to pediatric sibling eye check-up in a tertiary eye care hospital
Authors: Pawar Neelam , Ravindran Meenakshi , Fathima A , Ramakrishnan K , Sithiq Mohammed , Paranjape Mihir
Published: January 2023

Purpose:

To identify socio-economic, demographic, and clinical factors that may be associated with sibling access to ophthalmic check-up.

Methods:

A cross-sectional, descriptive study investigated children in the age group of 0–15 years under a project on Systematic Pediatric Eye Care Through Sibling Screening Strategies (SPECSSS project). The siblings of pediatric patients (proband) with refractive errors, strabismus, cataract, glaucoma, and retinal pathologies were given a referral card for ophthalmic check-up. If parents do not bring siblings for check-up within 1 month of initial information and even after 2 SMS reminders, it was considered as failure to uptake of services. On follow-up later, they were provided a questionnaire. A questionnaire was given to the parent by interview through a project coordinator, and details were obtained from the parents or caretaker. Parents who were willing for telephonic interview were asked to respond to the questionnaire over phone on the scheduled date. The sibling details, parent-related details, and data from questionnaire forms were entered and analyzed.

Results:

The mean age of 300 siblings was 9.3 ± 4.0 years with the majority of them being female (158). The most common reasons quoted by parents in the rural area compared with the urban area for not bringing siblings for eye exams were the travel distance from home to the hospital (n = 118, 83.7%), the travel time from home to the hospital (n = 109, 77.3%), more than one vehicle required to change (n = 111, 78.7%), and the transportation cost more than rupees 100 (INR) (n = 89, 63.1%) (p < 0.05). Unable to leave work responsibilities (n = 126, 79.3%) was stated more frequently by urban parents compared to rural (p = 0.039).

Conclusion:

Our study suggests that the financial factor, the distance factor, and social belief play an important role in timely uptake of sibling eye check-up. Targeting siblings with treatable pediatric eye diseases could help in reducing the burden of refractive error, strabismus, and cataract in the pediatric population.
Partial-thickness compression sutures without descemetopexy for management of acute hydrops in keratoconus: A novel surgical technique
Authors: Jain Neha , Shah Vishwa , Mittal Vikas , Yadav Vibha
Published: January 2023

This article reports a novel surgical technique of partial-thickness compression sutures without descemetopexy with air or gas for the management of acute hydrops in keratoconus. Two patients presented with localized corneal edema with a Descemet membrane (DM) tear in the left eye. Tomography of the right eye revealed localized steepening with increased maximum keratometry and decreased central pachymetry. They were diagnosed with keratoconus in the right eye and acute corneal hydrops (ACH) in the left eye. Compression sutures were passed through the stroma without touching the DM. The anterior chamber was not entered at all at any point during the surgery. Resolution of edema was noted intraoperatively itself. Further resolution of edema was noted from the first postoperative day which markedly reduced within the first week. A corneal scar with no edema was seen at six weeks. In both the patients, vision at presentation was counting fingers close to face which improved to 20/60 and 20/50, respectively, at the last visit.
Phaco-handpiece used as a Fragmatome for managing nucleus drop
Authors: Nene Amit S , Ramteke Pushpanjali , Shenoy Pratik , Shah Smitesh , Shah Sonal , Sheth Siddharth
Published: January 2023

Background:

Nucleus drop during cataract surgery is a dreaded complication and requires urgent vitreo-retinal intervention which is managed commonly using a fragmatome. However, a fragmatome is not readily available in routine ophthalmology set-ups because its use is very limited. On the other hand, a phaco-probe is commonly available with all surgeons and makes it cost-effective.

Purpose:

The purpose is to demonstrate the utility of a phaco-probe as an alternative to a fragmatome in managing nucleus drop during cataract surgery, making it cost-effective and less time-consuming and simple.

Synopsis:

The video shows two cases of complicated cataract surgery in which a nucleus is dropped in the vitreous cavity. The sleeve of the phaco-probe was removed, and infusion was disconnected to make it function as a fragmatome. We noted reduced lenticular repulsion from the phaco-handpiece tip as compared to the fragmatome, and no scleral burns were observed. The cases were completed by secondary placement of an intra-ocular lens in the sulcus in the same sitting. Thus, the phaco-probe can be considered to manage nucleus drop in the absence of a fragmatome.

Highlights:

A phaco-probe can be used as an alternative to a framgamtome, which is a cost-effective and simple technique.

Video link:

https://youtu.be/6c-40Bcijrc

Key words: Fragmatome, nulceus drop, phaco handpiece
Role of tenon advancement in treating limbal ischemia in acute chemical injury
Authors: Singh Prabhakar , Raj Amit , Abhishek  , Nanda Jayadev
Published: January 2023

Background:

In acute chemical injury, damage can range from ocular surface epithelial defects to limbal and scleral ischemia. This may subsequently progress to corneal or scleral melting and perforation and finally result in phthisis bulbi. Thus, acute chemical injury is a potentially blinding condition and warrants attention. The accurate technique to assess the damage incurred should be practiced to avoid undertreatment and subsequent complications. Surgical intervention wherever needed should be appropriately timed and should be performed. The primary aim of medical or surgical intervention in acute chemical injury is to attain a stable and epithelized ocular surface. Even a conjunctival phenotype over the cornea is a desirable outcome.

Purpose:

This video discusses the nuances involved in the assessment and planning of Tenon advancement with amniotic membrane grafting for treating limbal ischemia in acute chemical injury.

Synopsis:

The video demonstrates the technique of restoration of limbal vascularization by performing Tenon advancement with amniotic membrane grafting and its outcome.

Highlights:

Ocular surface painting with fluorescein dye is essential to assess the areas of surface involvement. Merely instilling the fluorescein dye in the cul-de-sac will underestimate the extent of the damage. Tenon advancement should ideally be planned between 7 and 10 days following an injury when actual limbal blanching is obvious. A stable and epithelized ocular surface is the desirable outcome irrespective of the epithelial phenotype.

Video Link:

https://youtu.be/06XhwLKnsIA.

Key words: Acute chemical injury, amniotic membrane grafting, tenon advancement
Posterior sub-Tenon triamcinolone injection in the treatment of postoperative cystoid macular edema secondary to pars plana vitrectomy
Authors: Erdogan Gurkan , Gumus Gulsah , Gunay Betul Onal , Ozkaya Abdullah
Published: January 2023

Purpose:

To evaluate the efficacy and safety of posterior sub-Tenon triamcinolone (PSTA) in chronic postoperative cystoid macular edema (PCME) after pars plana vitrectomy (PPV).

Methods:

Consecutive 22 patients who developed chronic PCME after PPV and underwent PSTA treatment were included in this retrospective study. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured pre injection and post injection at one month, three months, six months, and at last visit. The patients were divided into three groups according to the injection response status: complete, partial, and resistant.

Results:

The mean follow-up period was 26.4 ± 16.2 months after PSTA. According to pre-injection values, there was a significant improvement in the values of BCVA and CMT at the first, third, and sixth months and at the last examination (P < 0.05). In the final examination, PCME recovered completely in 12 patients, partially in 8 patients, and resistance was observed in 2 patients.

Conclusion:

Posterior sub-Tenon triamcinolone seems to be effective in chronic PCME following PPV.
Comparative study of conventional internal limiting membrane peeling versus temporal inverted internal limiting membrane flap for large macular hole treatment
Authors: Koçak Nurullah , Yeter Volkan , Birinci Hakkı
Published: January 2023

Purpose:

To compare the anatomical, morphological, and functional outcomes of the conventional internal limiting membrane (ILM) peeling versus temporal inverted ILM flap technique for large full-thickness macular holes (FTMHs).

Methods:

Sixty eyes of 60 patients with a minimum base diameter >600 mm were included in this retrospective interventional study. Patients were divided into conventional ILM peeling (Group 1) and temporal inverted ILM flap (Group 2) groups. The hole closure rate, best-corrected visual acuity (BCVA), ellipsoid zone (EZ), and external limiting membrane (ELM) defects were analyzed at baseline and 6 months after surgery.

Results:

Hole closure was achieved in 24/32 (75.0%) cases of Group 1 and 27/28 (96.4%) cases of Group 2 (P = 0.029). The mean BCVA (logMAR) changed from 1.23 ± 0.47 to 0.70 ± 0.29 logMAR in Group 1 and from 1.03 ± 0.36 to 0.49 ± 0.24 logMAR in Group 2 at 6 months (P < 0.001 in both cases). U-shaped closure was observed in 5 (15.6%) eyes in Group 1 and 19 (67.9%) eyes in Group 2 (P < 0.001). The total restoration rates of ELM and EZ were significantly higher in the temporal inverted ILM flap group (P = 0.002, P = 0.001, respectively).

Conclusion:

The study results suggested that the FTMH closure rate, recovery of the outer retinal layers, and, consequently, the post-operative BCVA were better with the temporal inverted ILM flap technique than with the conventional ILM peeling for larger than 600 mm macular holes.
Prevalence, pattern, and compliance with spectacles use among the elderly in homes for the aged in South India: The Hyderabad Ocular Morbidity in Elderly Study (HOMES)
Authors: Marmamula Srinivas , Bhoopalan Dharani , Kumbham Thirupathi R , Yelagondula Vijay Kumar , Keeffe Jill
Published: January 2023

Purpose:

This study was conducted to report on the pattern of spectacles use and compliance among the elderly (aged ≥60 years) in homes for the aged in Hyderabad region in Telangana State, India.

Methods:

Participants were recruited from 41 homes for the aged centres for comprehensive eye health assessments. A questionnaire was used to collect information on current and past use of spectacles, type of spectacles, spectacles provider and amount paid for the spectacles. For those that reported using spectacles in the past, information was collected on the reasons for their discontinuation. Compliance with spectacles use was assessed after eight months of provision of the spectacles.

Results:

A total of 1182/1513 participants were examined from 41 homes for the aged in Hyderabad, India. The mean age of the participants examined was 75 years (standard deviation (SD): 8.8 years; range: 60–108 years); 764 (64.6%) of them were women and 240 participants (20.3%) had no formal education. The prevalence of spectacles use was 69.9% (95% confidence interval [CI]: 67.1–72.4; n = 825). Bifocals were the most commonly used type of spectacles (86.7%) followed by single vision glasses for distance vision (7.4%). Private eye clinics were the largest service provider (85.5%) followed by local optical outlets (6.9%) and other service providers (7.7%). The prevalence of spectacles compliance was 81.5% (211/259).

Conclusion:

Use of spectacles and compliance are high among the elderly living in residential care homes in the Hyderabad region. Spectacles use can be further improved by periodic eye assessments along the lines similar to school eye programs, which can immensely benefit this vulnerable, aged population.
Monitoring Weil–Felix test in epidemic retinitis
Authors: Kawali Ankush , Sanjay Srinivasan , Mahendradas Padmamalini , Shetty Bhujang
Published: January 2023

Purpose:

The objective was to study the positivity of the Weil–Felix test (WFT) in epidemic retinitis (ER) during the course of the disease.

Methods:

This is a retrospective, observational case series of patients diagnosed with ER and presented to a tertiary eye care hospital in south India. Patients with positive WFT at the presentation, and who underwent a follow-up WFT during or after the resolution of ER were studied from September 2019 to March 2022. Patient’s demographics, timings of clinical presentation and resolution, and investigation details with a special focus on WFT positivity and its duration were noted.

Results:

Sixteen patients were studied. Patients presented after 5 weeks of the fever (range: 2-12 weeks, median: 4). After 1-2 months, WFT was still positive in eight patients (50%). Only in one patient titers increased after 1 month, while in others, the titers decreased (n= 11) or remained the same (n= 4). Repeated tests in those patients (n= 6) after 3-4 months turned negative. Resolution of ER was seen at 1.35 months (range: 1-3 months) after the presentation. The mean duration for WFT to turn negative was 2 months from the presentation (range: 1-4 months) or 3.2 months of the fever (range: 1.5-6 months).

Conclusion:

In contrast to the reported physician’s observation of increasing titers of WFT after rickettsial fever, ophthalmologists may observe decreasing WFT titers in ER. The clinical resolution of ER may precede the normalization of WFT. Follow-up WFT titers should be studied in larger series in confirmed cases of rickettsial-ER to validate the affordable and readily available WFT in India.
Vitreous hemorrhage – Causes, diagnosis, and management
Authors: Shaikh Nawazish , Srishti Ramamurthy , Khanum Aayesha , MB Thirumalesh , Dave Vivek , Arora Atul , Bansal Reema , Surve Abhidnya , Azad Shoryavardhan , Kumar Vinod
Published: January 2023

Vitreous hemorrhage is associated with a myriad of conditions such as proliferative diabetic retinopathy, proliferative retinopathy following vascular occlusion and vasculitis, trauma, retinal breaks, and posterior vitreous detachment without retinal break. Multiple pathological mechanisms are associated with development of vitreous hemorrhage such as disruption of abnormal vessels, normal vessels, and extension of blood from an adjacent source. The diagnosis of vitreous hemorrhage requires a thorough history taking and clinical examination including investigations such as ultra-sonography, which help decide the appropriate time for intervention. The prognosis of vitreous hemorrhage depends on the underlying cause. Treatment options include observation, laser photo-coagulation, cryotherapy, intravitreal injections of anti-vascular endothelial growth factor, and surgery. Pars plana vitrectomy remains the cornerstone of management. Complications of vitreous hemorrhage include glaucoma (ghost cell glaucoma, hemosiderotic glaucoma), proliferative vitreoretinopathy, and hemosiderosis bulbi.
Erythropoietin as a treatment option for indirect traumatic optic neuropathy: A pilot study
Authors: Kumar Mahesh , Kowsalya Akkayasamy , Narayanamoorthy Jayasri , Kumarasamy Dhivya , Chitradevi  , Balakrishnan Harinikrishna , Chaudhary Sameer
Published: January 2023

Purpose:

Our study aims to evaluate the effectiveness of intravenous erythropoietin (EPO) in patients with indirect traumatic optic neuropathy (TON), assess the side effects, and compare the visual function results among three groups of patients who had received different treatment options – EPO, steroids, and observation.

Methods:

Patients with indirect TON presenting to the neuro-ophthalmology clinic from August 2019 to March 2020, were assigned to three groups, with six patients in each group. In group 1, patients were recruited prospectively and received recombinant human erythropoietin, whereas, in groups 2 and 3, patients were recruited retrospectively and received intravenous methylprednisolone followed by oral steroids and multivitamins, respectively. Groups 1 and 2 included patients presenting within 2 weeks of trauma, whereas group 3 included those presenting beyond that. Best-corrected visual acuity, pupillary reaction, color vision, and visual fields following treatment were measured.

Results:

Initial visual acuity in the EPO group ranged from 20/80 to no perception of light (No PL). The mean initial BCVA (1.82 logMAR, standard deviation [SD] = 0.847) improved to 1.32, SD = 0.93 logMAR after treatment recorded at the third month (P = 0.0375), with no significant adverse effects. The initial BCVA of group 2 ranged from 20/120 to No PL. The mean initial BCVA (1.95, SD = 0.77 logMAR) improved to 1.45 logMAR, SD = 0.97 after treatment (P = 0.0435) but three patients had side effects of steroids. Initial visual acuity in Group 3 ranged from 20/40 to no PL. The mean initial BCVA (1.09 logMAR, SD = 1.10) worsened to 1.19 logMAR, SD = 1.06 after treatment after treatment (P = 0.0193). The improvement in BCVA when compared between the three groups was not significant.

Conclusion:

Both erythropoietin and steroids are effective in the management of traumatic optic neuropathy. However, erythropoietin shows lesser or no side effects when compared to steroids.
Designing and making an open source, 3D-printed, punctal plug with drug delivery system
Authors: Khanna Twisha , Akkara John D , Bawa Vedant , Sargunam Emmanuel A
Published: January 2023

With the advancement in the study of keratoconjunctivitis sicca and the scope of its treatment, punctal plugs are being widely used for the therapeutic management of dry eye disease. With the emergence of 3D printing in medicine, 3D printing of punctal plugs that have an inbuilt drug delivery system and also that can be personalized from patient to patient according to their punctum size can be a great therapeutic option. Another benefit of the device is that its printing takes a short period of time and is cost-effective. This study aimed at making an open source design and 3D printing an efficient model of a punctal plug with an inbuilt drug delivery system that can be eventually used for the treatment of various ocular diseases that require frequent drug instillation or blockage of the nasolacrimal pathway. The 3D design for the punctal plug was made using the open source application, FreeCAD, and slicing was done using the application ChituBox. After that, the plugs were printed using the LCD printer Crealty LD-002R. The material used was resin that was compatible with the Crealty LD-002R. Punctal plugs with satisfactory results were printed using the LCD printer. The punctal plugs showed suitable structure and were also easily reproduced in the 3D printer without any complications or setbacks.
Intussusception Secondary to Adenocarcinoma of the Colon
Authors: Duda Amber , Caparelli Michael L. , Braverman Timothy S , Cullen John P.
Published: January 2023

Intussusception in adults is a rare occurrence, accounting for approximately 1%–3% of bowel obstruction cases. Here, we present a case of colocolic intussusception of the sigmoid colon caused by adenocarcinoma. A 67-year-old male presented to the emergency department with abdominal pain and rectal bleeding. A computed tomography (CT) scan revealed intussusception involving the sigmoid colon and a potential mass. In the operating room, the patient underwent flexible sigmoidoscopy, followed by sigmoidectomy and end colostomy. Pathological examination of the resected specimen confirmed moderately differentiated adenocarcinoma of the sigmoid colon with negative margins, and two of the 54 lymph nodes were positive for metastasis. A repeat CT scan of the abdomen showed multiple sub-centimeter low-density hepatic lesions, and biopsy confirmed a metastatic lesion. The patient ultimately elected hospice care. In this report, we describe a rare case of sigmoid intussusception in an adult patient, review the relevant literature, and summarize the diagnostic and management approaches suitable for adult intussusception cases.
A Survey on the Practice of Enhanced Recovery After Elective Colorectal Surgery in Western Australia
Authors: Ng Zi Qin , Theophilus Mary
Published: January 2023

Background:

Enhanced Recovery After Surgery (ERAS) is a 24-item multidisciplinary questionnaire program designed to optimize the patient's perioperative care to reduce postoperative morbidity. However, its adoption remains largely influenced by region and the institution and surgeons' personal judgement.

Objectives:

This study aims to evaluate the practice of ERAS in elective colorectal surgery in Western Australia through a survey.

Design:

Prospective survey.

Setting:

The survey was sent to all surgeons identified to be performing routine elective colorectal surgery in Western Australia.

Patients and Methods:

A questionnaire was designed based on the latest ERAS guidelines, consisting of questions on the demographics of the surgeons, annual number of major colorectal resections, and on various aspects of pre-, intra- and postoperative practices. The questionnaire was sent through email or handed to the surgeons in August 2020 for a period of 2 months.

Sample Size:

Twenty-four eligible surgeons participated in the survey.

Main Outcome Measures:

The main outcome was to investigate the areas of agreement and difference in ERAS practice in elective colorectal surgery in Western Australia.

Results:

Twenty of the 24 eligible surgeons (83.3%) completed the questionnaire. Among these, 65% surgeons perform >50 major colorectal resections annually. There is a high agreement of the practice in certain areas: 70% surgeons perform >50% of their cases laparoscopically; they do not routinely use nasogastric tubes, majority of the surgeons do not routinely place drains after right (95%) and left (70%) colonic surgeries, 75% surgeons are guided by the Acute Pain Service for postoperative analgesia, and 95% surgeons encourage early mobilization. A few areas of practice remain widely variable: preoperative mechanical bowel preparation, postoperative fluids and electrolytes, and assessment of gut function.

Conclusion:

This survey provides a snapshot of the practice of ERAS in elective colorectal surgery in Western Australia. While certain aspects are considered as universal practice, there are some gaps and barriers to implementation that need to explored further.

Limitations:

The survey did not classify questions into open or laparoscopic surgery, and some surgeons worked both in public and private institutions, where practices may differ.
Preconcepciones identitarias de aspirantes a profesores de un Programa de Pedagogía Media de la ciudad de Santiago de Chile
Authors: Pérez Carrillo David Jacob , Ochoa Provoste Maria Alejandra , Rocha Monsalve Víctor Mario
Published: January 2023

El estudio de las preconfiguraciones identitarias de los estudiantes durante su formación inicial docente es un tema escasamente desarrollado, especialmente si se circunscribe a las etapas tempranas. El objetivo del artículo se orienta a caracterizar el conjunto de creencias, emociones y perspectivas acerca del proceso educativo, expresadas en preconfiguraciones identitarias de la profesión docente de la cohorte de estudiantes que postuló a un Programa de Pedagogía Media durante el año 2019. Para ello se analizaron sus respuestas a partir de dos instrumentos que se aplican a los aspirantes en la etapa de postulación, concluyéndose que las preconfiguraciones identitarias determinan en gran medida la trayectoria formativa de los futuros docentes y se constituyen en tropos claves para su accionar futuro a nivel de prácticas y saberes que enmarcan y dan sentido a su propio ejercicio profesional. Este trabajo se realizó con fondos de la Vicerrectoría Académica de Pregrado de la UDP.
Valoración de la docencia universitaria desde el enfoque socioformativo: propiedades de una escala para su evaluación
Authors: Zavala Guirado Martha Alejandrina
Published: January 2023

El presente estudio tiene dos objetivos, el primero es validar una escala para medir el desempeño del docente con las dimensiones del enfoque socioformativo, y el segundo es evaluar la práctica docente con dicha escala, para comprobar el apego hacia la socioformación. Para ello, se llevó a cabo un estudio instrumental y descriptivo, se construyó una escala con base al modelo teórico del enfoque socioformativo, ajustándose a cinco dimensiones: Mediación docente, Estrategias didácticas, Educación inclusiva, Evaluación valorativa y Formación integral. Por medio de 420 estudiantes se evaluaron a 28 docentes de una universidad de Sonora, México. Los resultados comprueban la validez de la escala por medio de un Análisis Factorial Confirmatorio y que los docentes muestran características deseables del enfoque. Se concluye que la escala muestra adecuadas propiedades psicométricas de consistencia interna y validez, además se demuestra que los docentes ponen en práctica los principios del enfoque socioformativo.
Construcción de la identidad docente de las educadoras de párvulos: Significados retrospectivos de su Formación Inicial Docente
Authors: Figueroa-Céspedes Ignacio , Guerra Paula , Madrid Alejandro
Published: January 2023

El presente artículo analiza los significados que dos educadoras de párvulos experimentadas elaboran en torno a la construcción de su identidad docente en el escenario de su pregrado. Se empleó un estudio de caso con orientación biográfico-narrativa, utilizando entrevistas semiestructuradas con foco en la exploración de sus experiencias en la Formación Inicial Docente (FID), las que se analizaron a través de un análisis temático en el que se agruparon los significados más relevantes. Los resultados están ligados a experiencias de la vida personal, la construcción de la noción de profesionalismo, el despliegue de competencias y habilidades pedagógicas, la valoración de la práctica profesional, la presencia de docentes significativas y la universidad como escenario institucional. Se concluye que los significados priorizados dan cuenta de la tensión entre profesionalismo y reconocimiento que fluctúa entre lo personal y profesional, experimentando una desvalorización de su quehacer.
Revisión sistemática sobre autorregulación del aprendizaje en estudiantes de secundaria
Authors: Sáez-Delgado Fabiola , López-Angulo Yaranay , Nicole Arias-Roa Nicole , Mella-Norambuena Javier
Published: January 2023

El aprendizaje autorregulado es una variable clave para el éxito académico. El objetivo de esta investigación fue sistematizar descriptivamente investigaciones empíricas cuantitativas sobre aprendizaje autorregulado en estudiantes de secundaria en el periodo 2015 a 2020. Se empleó la metodología de revisión sistemática PRISMA-P. Fueron seleccionados 21 artículos. Los resultados mostraron que (1) las investigaciones se concentraron principalmente en Europa y Asia, (2) la muestra estuvo entre 101 y 500 estudiantes, (3) el diseño más empleado fue el correlacional, (4) las variables más abordadas fueron de las estrategias de aprendizaje, (5) el instrumento más utilizado para medir ARA fue el de Pintrich, Smith, García y McKeachie (1991), y (6) las limitaciones involucran aspectos de validez interna y externa de las investigaciones. Las insuficiencias metodológicas identificadas podrían poner en riesgo el impacto favorable de las intervenciones; en Latinoamérica es necesario avanzar en el diseño de investigaciones con alta validez, esto garantizaría obtener los resultados esperados.
Investigación en diversidad e inclusión en la formación inicial docente: análisis bibliométrico y temático (2011-2020)
Authors: Lagos San Martín Nelly Gromiria , Garay Alemany Victoria Verónica , Núñez Rojas Mauricio Alejandro , Gallardo Jaque Alejandro , Reinoso Salinas Daysi Jasmin , Nilo Cea Rosa Isabel , Morales Mejías Patricia Elizabeth , Soto Aranda Erika Viviana Del Carmen , Troncoso Popovic Ivka Silvana , Arévalo Vera Ana Rosa , Díaz Suazo Pamela Alejandra
Published: January 2023

Dada la relevancia actual de la investigación acerca de cómo se aborda la educación en y para la diversidad en la educación superior, es que este trabajo tiene por objetivo analizar la literatura cientíﬁca sobre diversidad e inclusión en la educación superior publicada en la Web of Sciences y Scopus entre 2011 y 2020. Se analizaron 112 artículos en función de indicadores bibliométricos: producción temporal, por revistas y autor, fuentes de información, instrumentos y procedimientos, y análisis temático. Los hallazgos indican un aumento de productividad en el 2019, una tendencia a la colaboración, un predominio de estudios cuantitativos, y temáticas sobre creencias, actitudes y saberes, formas de diversidad y educación para la diversidad. Estos hallazgos respaldan la necesidad de avanzar hacia nuevas comprensiones de diversidad de este tópico de investigación.
Estrategias adaptativas y de autorregulación de profesores en pandemia Covid-19
Authors: Díaz Cánepa Carlos Ignacio , Alcapán Regla Aracelly , Figueroa Zapata Elías , Mella Araya Cristián , Morales Olivares Ítalo , Palma Trujillo Alvaro , Toro Vidal Lilian
Published: January 2023

La masiva y abrupta implementación de educación online ha generado una serie de nuevos desafíos a los profesores, implicando el despliegue de importantes procesos adaptativos y autorregulatorios. Este texto aborda, a partir del análisis de entrevistas a profesores de educación básica, las formas en las que dichos procesos se manifiestan. En base a estos antecedentes, se proponen líneas de investigación y de arreglo de las condiciones en que se desarrolla la docencia online, desde la ergonomía cognitiva.
Corporeidad en educación infantil: visión crítica de su (in)visibilización en contextos sobreescolarizados
Authors: Ahumada Ugalde Pabla , Rojas Cisternas Camila Constanza , Soto Silva Claudia Andrea , Varas Cerda Paula Macarena , Fernández Fuentes Constanza Camila , Gamboa Jiménez Rodrigo
Published: January 2023

La presente investigación de enfoque cualitativo tiene por objetivo analizar las percepciones expresadas por un grupo de expertos, y su relación con las propuestas pedagógicas realizadas en aula de educación infantil, en torno a los procesos de sobreescolarización y su vinculación con la (in)visibilización del cuerpo en las distintas experiencias de aprendizaje. Se aplicaron entrevistas a expertos en el área de estudio y se observó a educadoras infantiles de dos realidades educativas de la ciudad de Viña del Mar, Chile. El análisis de la información se ha realizado siguiendo las directrices de fragmentación y articulación propuestas por la teoría fundamentada. Los hallazgos revelan la presencia de prácticas pedagógicas sobreescolarizadas en la infancia; prácticas educativas que invisibilizan el cuerpo en los distintos procesos de aprendizaje, privilegiando aspectos cognitivos por sobre otras dimensiones de la persona.
Argumentar y contraargumentar en la Formación Inicial Docente: un dispositivo pedagógico orientado a desarrollar pensamiento docente reflexivo
Authors: Albornoz Muñoz Natalia , Corbalán Pössel Francisca , Acuña Ruz Felipe , Sanhueza Céspedes Macarena
Published: January 2023

La reflexión es imperativa para ejercer la profesión docente. Sin embargo, encontrar espacios para el desarrollo del pensamiento reflexivo es difícil en la formación inicial y en el ejercicio docente. Se presenta la ejecución y evaluación de un Dispositivo Pedagógico de Argumentación para promover pensamiento reflexivo. Específicamente, el objetivo del artículo fue describir cómo los protagonistas significaron el dispositivo. Participaron estudiantes de segundo año de Pedagogía de una universidad estatal regional. La evaluación de la experiencia del dispositivo fue realizada a través de tres grupos focales con estudiantes, ayudantes y docentes. En esta evaluación, los participantes destacan el carácter novedoso de la intervención, la dimensión colaborativa de su implementación y su potencial para promover reflexión y toma de perspectiva con respeto y tolerancia. No obstante, identifican también dificultades administrativas y de gestión del tiempo. Como emergente, los resultados muestran la importancia que toma el futuro como eje de la reflexión.