bluuebunny/crossref_metadata_2025_split huggingface dataset:
They see, they learn: Pre-COVID-19 prevalence of refractive errors in school children in suburban areas of North India
Authors: Sethi Aditya , Sethi Arun , Sethi Reena , Sethi Sahebaan , Sethi Vaibhav , Lokwani Parul , Chilwade Manisha 
Published: March 2023

Purpose:
India has the largest population of youth in the world, thereby making them important contributors to the “India of Tomorrow”. Over 80% of knowledge gained is by the visual sense, thereby making school screening programs a necessity in our country. Data from the pre-COVID era, that is, 2017–18 was collected from close to 19,000 children in Gurugram, Haryana, a tier two city in National Capital Region, India. A similar prospective observational study is planned post COVID-19 (2022–23) for further analysis to depict the impact of COVID-19 in these areas.

Methods:
The program They See, They Learn was set at government schools in the area of operations (district of Gurgaon, Haryana), where the children and their families were unable to afford eye care services. All children who were screened underwent a comprehensive eye examination at the school premises itself.

Results:
A total of 18,939 students were screened over a period of 18 months, covering a total of 39 schools in the Gurugram belt, in the first phase of the program. Eleven point eight percent (n = 2254) of all school students had some form of refractive error. Girl students were found to have a higher refractive error rate (13.3%) compared to boy students (10.1%) across the schools screened. Myopia was the most common type of refractive error.

Conclusion:
School students require perfect vision or else they can be discouraged and may become a major burden to the economy of any developing nation. A school screening program aiming at populations that cannot afford such basic needs like spectacles is a must in all zones of the country.
A study on childhood microbial keratitis in South India
Authors: Chandratreya Madhura P , Mudduluru Deepthi , Venugopal Anitha , Varghese Anitt K , Ghorpade Aditya S 
Published: March 2023

Purpose:
The aim of this study was to determine the predisposing risk factors, clinical characteristics, microbiological profile, and visual and functional treatment outcome of microbial keratitis including viral keratitis in children.

Methods:
A prospective study was carried out in a tertiary care institute over a period of 18 months on 73 pediatric patients. Data collected was analyzed for demographics of the patient population, causative organisms, and management outcome in terms of visual and functional outcome.

Results:
Patients in the age group from 1 month to 16 years were included, with a mean age of 10.81 years. Trauma was the commonest risk factor (40.9%), with unidentified foreign body fall being the most common (32.3%). No predisposing factors were identified in 50% of cases. Also, 36.8% of eyes were culture positive, with bacterial isolates in 17.9% and fungus in 82.1%. Moreover, 7.1% eyes were culture positive for Streptococcus pneumoniae and Pseudomonas aeruginosa each. Fusarium species (67.8%) was the commonest fungal pathogen, followed by Aspergillus species (10.7%). Also, 11.8% were clinically diagnosed as viral keratitis. No growth was found in 63.2% of patients. Treatment with broad-spectrum antibiotics/antifungals was administered in all cases. At the final follow-up, 87.8% achieved a best corrected visual acuity (BCVA) of 6/12 or better. Therapeutic penetrating keratoplasty (TPK) was required by 2.6% of eyes.

Conclusion:
Trauma was the major cause for pediatric keratitis. Majority of the eyes responded well to medical treatment, with only two eyes needing TPK. Early diagnosis and prompt management helped majority of the eyes to achieve a good visual acuity after the resolution of keratitis.
Study to evaluate the relation between weight gain in infants and occurrence of retinopathy of prematurity
Authors: Sethi Neha K , Jain Barkha , Gupta Natha Ram , Singh Surinder Pal , Sethi Gurmeet , Chadha Charu 
Published: March 2023

Purpose:
Retinopathy of prematurity (ROP) is a leading cause of childhood blindness. Capturing serial daily postnatal weight gain can act as an innovative, low-cost method of risk stratification. We aim to study the relation between weight gain in infants and occurrence of ROP.

Methods:
The prospective, observational study was conducted on 62 infants. ROP screening was done based on the Rashtriya Bal Swasthya Karyakram (RBSK) criteria. Infants were classified into no ROP (n = 28), mild ROP (n = 8), and treatable ROP (n = 26) groups. Average daily postnatal weight gain was measured and its relation to development of ROP was studied. All statistical calculations were done using Statistical Package for the Social Sciences (SPSS) 21 version (SPSS Inc., Chicago, IL, USA) statistical program for Microsoft Windows.

Results:
Mean rate of weight gain in no ROP group, mild ROP group, and treatable ROP group was 33.12, 27.19, and 15.31 g/day, respectively (P = 0.001). Mean gestational age and birth weight in treatable group (n = 26) were 31.38 weeks and 1572.31 g, respectively. Receiver operating curve analysis revealed a cutoff of 29.33 g/day for ROP and 21.91 g/day for severe ROP.

Conclusion:
We concluded that, babies with poor weight gain of below 29.33 g/day are at high risk for ROP and babies with wight gain of 21.91 g/day are at high risk for severe ROP. These babies should be followed meticulously. So, the rate of weight gain of a preterm can help us to prioritize babies.
Estimation of surgically induced astigmatism after small-incision cataract surgery done by junior residents
Authors: Thakre Uttkarsha D , Nikose Archana S , Momin Aseera 
Published: March 2023

Purpose:
To estimate the postoperative astigmatism after small-incision cataract surgery (SICS) done by junior residents at the end of 1 and 3 months.

Methods:
This observational longitudinal study was conducted at the Department of Ophthalmology of a tertiary eye care hospital and research center. 50 patients enrolled in the study underwent manual small incision cataract surgery by junior residents. Preoperative detailed ocular examination was done, which included keratometric estimation using autokeratometer (GR-3300K). Incision length, distance of incision from the limbus, and type of suturing technique were noted. Postoperatively, keratometric readings were noted at 1 and 3 months. Astigmatism (surgically induced astigmatism [SIA]) was estimated using Hill’s SIA calculator version 2.0. All the analyses were performed using Statistical Package for the Social Sciences (SPSS) ver. 26.0 (IBM Corp., USA) software, and the statistical significance was tested at a 5% level.

Results:
Out of 50 patients, 54% had SIA between 1.5 and 2.5 D and 32% had SIA of more than 2.5 D. Only 14% had SIA less than 1.5 D at the end of 1 month. While 52% had SIA between 1.5 and 2.5 D, 22% had SIA between 1.5 and 2.5 D and 26% had SIA less than 1.5 D at the end of 3 months.

Conclusion:
The SIA in most of the SICS done by junior residents was above 1.5 D. It depended mainly on the incision length, its distance from the limbus, and the suturing technique.
Comparative study to evaluate retinal changes using spectral-domain optical coherence tomography in diabetics without diabetic retinopathy
Authors: Harwal Niveditha , Shashidhar S , Hithashree H R , Bypareddy Ravi , Vishwanath B N 
Published: March 2023

Purpose:
To elucidate changes in the neuro-sensory retina at the macula, using spectral-domain optical coherence tomography (SD-OCT) in type 2 diabetics without clinical signs of diabetic retinopathy, and compare with healthy subjects.

Methods:
This was a cross-sectional observational study, conducted at a tertiary eye institute from November 2018 to March 2020. Type 2 diabetics visiting the outpatient department with normal fundus (without any clinical signs of diabetic retinopathy) were taken as Group 1, and healthy subjects as Group 2. Both underwent recording of visual acuity, intraocular pressure (non-contact tonometry), slit-lamp anterior segment examination, fundus examination using an indirect ophthalmoscope, and macular SD-OCT. SPSS (Statistical Package for Social Sciences) version 20 [IBM SPSS statistics (IBM corp. Armonk, NY, USA released 2011)] was used to perform the statistical analysis of the data entered in the excel sheet.

Results:
Our study included 440 eyes of 220 subjects, divided equally into two groups. The mean age of patients with diabetes was 58.09 ± 9.42 years, and of controls 57.25 ± 8.91 years. The mean BCVA in group 1 and group 2 was 0.36 ± 0.37 and 0.21 ± 0.24 logMAR, respectively. SD-OCT showed thinning in all areas in group 1 compared to group 2, but statistically significant thinning was seen only in the central subfield (P = 0.0001), temporal parafoveal (P = 0.0001), temporal perifoveal (P = 0.0005), and nasal perifoveal areas (P = 0.023) in group 1. There was a significant inter-eye difference noted between the right and left eyes in nasal and inferior parafovea only in group 1 (P = 0.03). No significant difference was noted between males and females.

Conclusion:
There was significant macular thinning in diabetics compared with controls, which denotes the occurrence of neuronal damage in these eyes before clinical evidence of diabetic retinopathy.
Cataract versus combined surgery in pseudoexfoliation glaucoma
Authors: Rao Aparna , Cruz Rakhi D 
Published: March 2023

Purpose:
Pseudoexfoliation glaucoma (XFG) is often associated with a higher rate of intraoperative complications and failure. This study aims to compare the long-term clinical and surgical outcomes of cataract surgery alone versus combined surgery in XFG. This was a retrospective comparative case series.

Methods:
All patients with XFG who underwent either cataract surgery alone [group 1: either phacoemulsification, PHACO/small-incision cataract surgery (SICS), n = 35] or combined surgery (group 2: phacotrabeculectomy, PHACOT or SICS + trabeculectomy, n = 46) from 2013 to 2018 by a single trained surgeon were screened and recalled for a detailed clinical examination, including Humphrey visual field analysis at 3-monthly intervals for a minimum of 3 years. Surgical success (intraocular pressure, IOP, <21 mm Hg and >6 mm Hg with (qualified success) or without medicines, complete success, survival rates, visual field changes, and need for additional procedures/medicines for IOP control were compared between groups.

Results:
A total of 81 eyes of 68 patients with XFG were included in this study (groups 1–35 eyes and groups 2–46 eyes each). Both groups achieved 27–40% IOP reduction from preoperative IOP levels, P < 0.001. Surgical success rates were similar in both groups (complete success 66% vs 55%, P = 0.4), qualified success 17% vs 24%, P = 0.8, in groups 1 and 2). Kaplan–Meier analysis showed a marginally better survival rate for group 1, 75% (55–87%), than group 2, 66% (50–78%), at 3 and 5 years which was not significantly different. The number of eyes that progressed at 5 years after surgery (5–6%) was similar in both groups.

Conclusion:
Cataract surgery can be as effective as combined surgery in XFG eyes with regards to final visual acuity, long-term IOP profile, and visual field progression, and complications/survival rates are comparable between the two procedures.
The complication rate following Neodymium-doped Yttrium Aluminum Garnet laser posterior capsulotomy for posterior capsular opacification in patients with and without comorbidities
Authors: Joshi Rajesh S , Doble Pallavi 
Published: March 2023

Purpose:
To study the complication rate following Nd: YAG posterior capsulotomy posterior capsular opacification (PCO) in patients with and without comorbid conditions.

Methods:
This was a prospective, interventional, comparative, and observational study. A total of 80 eyes, consisting of 40 eyes without ocular comorbidities (group A) and 40 eyes with ocular comorbidities (group B) that were being treated with Nd: YAG capsulotomy for PCO, were included. Visual outcome and complications of Nd: YAG capsulotomy were studied.

Results:
The mean age of group A patients was 61.65 ± 8.85 years and that of group B patients was 63 ± 10.46 years. Of the total, 38 (47.5%) were men and 42 (52.5%) were women. In group B, the ocular comorbidities were moderate nonproliferative diabetic retinopathy (NPDR) (n = 14 eyes; 14/40 = 35%), subluxated intraocular lens (IOL; <2 clock hours of subluxation; n = 6), age-related macular degeneration (ARMD; n = 6), post-uveitic eyes (having old signs of uveitis, no episode of uveitis since the last 1 year; n = 5), and operated cases of traumatic cataract (n = 4). The mean energy required in groups A and B was 46.95 ± 25.92 and 42.62 ± 21.85 mJ, respectively (P = 0.422). The average energy requirement in Grade 2, Grade 3, and Grade 4 PCO was 22.30, 41.62, and 79.52 mJ, respectively. An increase in intraocular pressure (IOP) of >5 mmHg from pre-YAG levels was observed in one patient in each group on day 1 postprocedure, for which medical treatment was given to both patients for 7 days. One patient in each group had IOL pitting. No patient had any other complications attributable to ND:YAG capsulotomy.

Conclusion:
Nd:YAG laser posterior capsulotomy is a safe procedure for PCO in patients with comorbidities. Visual outcomes were excellent after Nd:YAG posterior capsulotomy. Although a transient increase in IOP was noted, the response to treatment was good and a long-term increase in IOP was not observed.
Consensual eye intra-ocular pressure rise following unilateral glaucoma surgery
Authors: Rajsrinivas Divya , Dubey Suneeta , Pegu Julie , Majumdar Atanu 
Published: March 2023

Purpose:
Consensual eye intra-ocular pressure (IOP) increase has been reported following ipsilateral glaucoma surgery. The study evaluated the need for increase in anti-glaucoma medications (AGM) ± glaucoma surgery to control the IOP in consensual eye following unilateral glaucoma surgery.

Methods:
Data of 187 consecutive patients who underwent either trabeculectomy or AGV implant were collected. Index (IE) and fellow eye (FE) IOP (baseline, follow-up day 1, week 1, months 1 and 3), acetazolamide and AGM use, FE surgery, glaucoma status, and relevant ophthalmological data were collected.

Results:
A significant increase from a baseline IOP of 14.4 mmHg was noted at week 1 (15.8 mmHg, p-0.005) and month 1 (15.62 mmHg, p-0.007) in FE (n-187). Among the 61 patients (33%, n-187) who needed additional intervention to reduce FE IOP, 27 (14.4%) underwent FE trabeculectomy. In the IE trabeculectomy group (n-164), significant increase in FE IOP was noted in week 1 (15.87 mmHg, p-0.014) and month 1 (15.61 mmHg, p-0.02), and in the IE AGV group (n-23) at day 1 (15.91 mmHg, p-0.06). Pre-operative acetazolamide resulted in significant increase in FE IOP at week 1 and month 1. Maximum increase in FE IOP of nearly 3.5 mm Hg was noted when IE IOP was persistently <5 mmHg at one month following surgery. Mean FE IOP remained elevated at all visits.

Conclusion:
An increase in fellow eye IOP needing any additional intervention in a third and surgical intervention in nearly a sixth meant that FE IOP be strictly monitored and addressed following unilateral glaucoma surgery.
Anatomical and surgical considerations and outcomes in infantile Terson syndrome
Authors: Bhende Pramod , Maitra Puja 
Published: March 2023

Purpose:
To study the presentation and outcomes of infantile Terson syndrome (TS).

Methods:
This was a retrospective analysis of 18 eyes of nine infants diagnosed to have TS-related intraocular hemorrhage (IOH).

Results:
Nine infants (seven males) were diagnosed to have IOH secondary to TS, of which eight infants had imaging features suggestive of intracranial bleed meeting our definite criteria. Median age at presentation was 5 months. In 11 eyes of six infants with suspected birth trauma, the median age of presentation was 4.5 months (range 1–5 months) of which one baby had a history of suction cup-aided delivery and four babies had a history of seizures. Vitreous hemorrhage (VH) was noted in 15 eyes (extensive in 11 eyes). Ten of these eyes showed membranous vitreous echoes, or triangular hyperechoic space with apex at the optic nerve head (ONH) posteriorly and base at the posterior lens capsule anteriorly, with or without dot echoes in the rest of the vitreous cavity, with a configuration of “tornado-like hemorrhage” suggestive of Cloquet’s canal hemorrhage (CCH). Eight eyes underwent lens-sparing vitrectomy (LSV) and one eye underwent lensectomy with vitrectomy (LV). On follow-up, disc pallor and retinal atrophy were noted in 11 and 10 eyes, respectively. The mean follow-up was 62 months (1.5 month–16 years). Visual acuity/behavior improved in all cases at the final follow-up. Developmental delay was noted in four children.

Conclusion:
Unexplained and altered vitreous hemorrhage with typical ultrasonography (USG) features should raise the suspicion of CCH in TS. Despite early intervention to clear visual axis, anatomical and visual behavior may remain subnormal.
Clinical features of early-onset pediatric traumatic glaucoma and predictive factors for the need of early glaucoma surgery
Authors: Shah Chintan , Sen Pradhnya , Tabani Salma , Prasad Kailash , Peeush Parimal , Jain Elesh 
Published: March 2023

Purpose:
To assess the clinical presentation of pediatric patients having early traumatic glaucoma and to analyze early predictors for the need of filtration surgery.

Methods:
Patients with early traumatic glaucoma after close globe injury (CGI) from January 2014 to December 2020 were retrospectively reviewed. Clinical features, treatment provided (medical and surgical), and visual outcomes were documented. Patients were divided into two groups based on the management required: group A- trabeculectomy and group B- medication + minor surgery.

Results:
A total of 85 patients were studied after applying the necessary inclusion and exclusion criteria. Out of these, 46 underwent trabeculectomy for the control of intraocular pressure (IOP) and the remaining 39 were managed with antiglaucoma medications. Significant male predominance of 9.6:1 was observed. Patients presented to the hospital after a mean duration of 8.5 days posttrauma. Wooden objects were most commonly responsible for trauma. Mean best corrected visual acuity at presentation was 1.91 log of minimum angle of resolution (logMAR). Mean IOP at presentation was 40 mmHg. The common anterior segment finding were severe anterior chamber (AC) reaction (63.5%), followed by angle recession (56.4%). Severe AC reaction (P = 0.0001) and corneal microcystic edema (P = 0.04) were significant predictive factors for early need of trabeculectomy.

Conclusion:
Need of trabeculectomy was higher in patients with severe AC reaction and corneal microcystic edema. The threshold to perform trabeculectomy should be lower, as glaucoma is often relentless, severe, and may result in irreversible vision loss.
Outcomes of refractive implantable lens implantation after deep anterior lamellar keratoplasty
Authors: Reddy Jagadeesh , Dani Samruddhi , Sundaram Vandhana 
Published: March 2023

Purpose:
To assess the refractive outcomes and effect on endothelial cell density of refractive implantable lens (RIL) implantation following deep anterior lamellar keratoplasty (DALK).

Methods:
A retrospective study was conducted on 10 eyes of 10 patients who had undergone DALK and subsequently underwent toric RIL implantation. The patients were followed up over a period of 1 year. The parameters compared were uncorrected and best corrected visual acuity, spherical and cylindrical acceptance, mean refractive spherical equivalent, and endothelial cell counts.

Results:
There was a significant improvement (P < 0.05) from preoperatively to 1 month postoperatively in the mean log of minimum angle of resolution (logMAR) uncorrected distance visual acuity (UCVA; 1.1 ± 0.1 to 0.3 ± 0.1), spherical refraction (5.4 ± 3.8 to 0.3 ± 0.1 D), cylindrical refraction (5.4 ± 3.2 to 0.8 ± 0.7 D), and MRSE (7.4 ± 3.5 to 0.5 ± 0.4 D). Three patients achieved spectacle independence for distance vision with a residual MRSE less than 1 D in the other cases. A stable refraction was maintained up to 1 year follow-up in all cases. There was a 2.3% mean decline in endothelial cell counts at 1 year of follow-up. No intraoperative or postoperative complications were seen in any case up to 1 year of follow-up.

Conclusion:
RIL implantation is an effective and safe procedure for the correction of high ametropia post-DALK.
Knowledge, attitude, and practice of childhood myopia among Indian optometrists: A questionnaire-based study
Authors: Chaurasiya Ritesh Kumar , Sutar Samir , Gupta Akansha , Pandey Ramji , Agarwal Pradeep 
Published: March 2023

Purpose:
To investigate the knowledge of myopia and its natural history including complications and clinical approaches for management adopted by optometrists across India.

Methods:
An online survey was distributed to Indian optometrists. A pre-validated questionnaire was adopted from previous literature. Respondents provided information about their demographics (gender, age, practice location, and modality), myopia knowledge, self-reported practice behaviors relating to childhood myopia, the information and evidence base used to guide their practice, and perceived extent of adult caregiver engagement in making management decisions for myopic children.

Results:
A total of 302 responses were collected from different regions of the country. Most respondents demonstrated knowledge of the association between high myopia and retinal breaks, retinal detachment and primary open-angle glaucoma. Optometrists used a range of techniques to diagnose childhood myopia, with a preference for non-cycloplegic refractive measures. The most common approaches to management were single-vision distance despite most optometrists identifying orthokeratology and low-dose (0.01%) topical atropine as two potentially more effective therapeutic interventions for controlling childhood myopia progression. Almost 90% of respondents considered increasing the time spent outdoors to be beneficial for reducing the rate of myopia progression. The main sources of information used to guide clinical practice were continuing education conferences, seminars, research articles, and workshops.

Conclusion:
Indian optometrists appear to be aware of emerging evidence and practices, but are not routinely adopting measures. Clinical guidelines, regulatory approval, and sufficient consultation time may be of value for assisting practitioners in making clinical decisions based on the current available research evidence.