bluuebunny/crossref_metadata_2025_split huggingface dataset:
Orbital dermoid cyst
Authors: Bansal Rolika , Honavar Santosh G , Talloju Shiva Shankar , Mulay Kaustubh 
Published: February 2022

Background:
Dermoid cyst, a developmental benign choristoma, is the most common orbital tumor of childhood, arising from ectodermal sequestration along the lines of embryonic fusion of mesodermal processes, lined by keratinized stratified squamous epithelium and expanding slowly due to constant desquamation and dermal glandular elements. Approximately 80% are found in the head and neck region and comprise 3-9% all orbital masses.

Purpose:
It is mandatory to know about the variable presentations of orbital dermoids and the surgical techniques that can be adopted based on the site, extent, age and aesthetic needs, presence of inflammation and possibility of intraoperative rupture.

Synopsis:
Orbital dermoids can be classified as juxta-sutural, sutural or soft tissue cysts; superficial or deep; intraosseous or extraosseous, and intraorbital or extraorbital. These smooth, painless, mobile or partially mobile lesions mostly present at the fronto-zygomatic suture with proptosis, displacement, ptosis or diplopia, depending on depth and extent. Therefore, it is important to understand the various presentations and the appropriate surgical techniques.

Highlights:
We describe the embryological origin, types and clinical features of dermoids in this video and demonstrate the surgical and minimally invasive techniques for their management. Video link: https://youtu.be/-q3xD2igjcQ
A neophyte gonioscopist’s animative and videographic atlas with focal points for effective practice
Authors: Ramesh Prasanna Venkatesh , Parthasarathi Sathyan 
Published: February 2022

Background:
Though various gonioscopy teaching platforms are available, they predominantly comprise of real time scenarios and videos. For a beginner, we suggest providing animations of the real time scenario for cognitive training; and then putting them in real time scenarios for a better concept application and practice.

Purpose:
This video highlights the basic tips and tricks needed to perform gonioscopy with metaphorical conceptual learning matching the 2D and 3D animations with real time scenarios.

Synopsis:
Simple and practical scenarios with technical details on how to perform gonioscopy and various challenges are shown. All the animations and videos are created by us, tailored to a neophyte. The following concepts are covered: normal angle (animation versus real-time), dynamicity of the gonioscopic dates of person, methods of gonioscopy - direct and Indirect, precautions and slit lamp adjustment, bubble trouble, patient examination, iris process versus peripheral anterior synechiae (animation versus real-time), patient examination (angle viewing order) for different lens, how to remove gonioscopy lens from the eye, static versus dynamic gonioscopy, situations where gonioscopy is contraindicated, grading of the angle (with animations), clinical scenarios (pseudoexfoliation, pigment dispersion, angle recession and aniridia), and surgical scenarios (patent ostium and blocked ostium).

Highlights:
Multiple animations and real-time videos with focal points for effective practice are the highlights of this video. Video link: https://youtu.be/fFmPmqgdjyM
Post-operative outcomes of small-incision lenticule extraction in patients with moderate to high astigmatism
Authors: Arulmozhi Varman N V , Varman Aadithreya , Balakumar Dinesh 
Published: February 2022

Purpose:
To evaluate the visual outcomes of patients who underwent small-incision lenticule extraction (SMILE) for the treatment of myopic astigmatism with high cylinders (>2.5 diopters, D).

Methods:
Forty-two eyes of myopic astigmatism with a spherical error of magnitude between − 0.5 and − 6.0 Ds, cylindrical error of − 2.5 to − 4.5 Dcyl were included in the retrospective study. All patients were tested preoperatively and on days 1, 10, and 30 for uncorrected distance visual acuity, manifest refraction, and corrected distance visual acuity. Additional preoperative assessments were done including measurement of corneal thickness, corneal topography, and examination for ocular surface disease. All procedures were performed by a single experienced surgeon. VisuMax laser system (Carl Zeiss Meditec AG, Jena, Germany) was utilized for all the corrective refractive procedures.

Results:
Forty-two eyes were included. The logarithm of the minimum angle of resolution Uncorrected distance visual acuity (UDVA) was 1 ± 0.25 preoperatively and 0.00 ± 0.00 on postoperative day 30. There was no loss of corrected distance visual acuity (CDVA) lines.

Conclusion:
SMILE is a successful procedure in the treatment of both myopic spherical and cylindrical refractive errors including high cylindrical errors >-3 to − 4.5 Dcyl.
Lowering of intraocular pressure after phacoemulsification in primary open-angle and angle-closure glaucoma: Correlation with lens thickness
Authors: Kader Mohideen Abdul , Pradhan Arkaprava , Shukla Aakriti Garg , Maheswari Devendra , Ramakrishnan R , Midya Debahuti 
Published: February 2022

Purpose:
To assess anterior chamber configuration changes during phacoemulsification in primary angle-closure suspect (PACS/PAC) and primary open-angle glaucoma (POAG).

Methods:
Prospective observational comparative study of anterior segment optical coherence tomography (AS-OCT) findings before and after phacoemulsification on three groups of patients (PACS/PAC, POAG, and controls). Data were collected over a period of 9 months. Main outcome measures included mean change in anterior chamber depth (ACD), angle opening distance (AOD), and trabecular iris space area (TISA).

Results:
153 patients (51 PACS/PAC, 51 POAG, and 51 controls) were included in the study. Change in all parameters (ACD, AOD at 500 um, and AOD at 750 um) between the groups demonstrated a greater change in PACS/PAC as compared to POAG and controls. AOD at 750 μm in the temporal quadrant, which has been considered to be having the highest correlation or best representation of the angle, increased in all groups after phacoemulsification (463.59 ± 10.99 vs. 656.27 ± 9.73 mm in PACS; 521.29 ± 16.36 vs. 674.37 ± 8.72 mm in POAG; 549.27 ± 12.40 vs. 702.82 ± 13.04 mm in controls, (P < 0.001). After phacoemulsification, intraocular pressure (IOP) decreased by 2.75 ± 1.17 mm Hg in PACS/PAC (P < 0.001), 2.14 ± 1.33 mm Hg in POAG and 1.90 ± 1.25 mm Hg in controls and it was statistically significant in the PACS group compared to control (P < 0.001).

Conclusion: Phacoemulsification with intraocular lens implantation is associated with increase in the ACD and angle parameters and a corresponding decrease in IOP. Findings were more pronounced in PACS/PAC suggesting early phacoemulsification may be a treatment option in this group.
Winning the battle of refractory hypotony
Authors: Maheshwari Devendra , Shyam Priyanka , Pawar Neelam , Ramakrishnan Rengappa 
Published: February 2022

Background:
Trabeculectomy, a mainstay in the management of glaucoma is associated with various complications, the most dreaded being hypotony.

Purpose :
We present a challenging case of late-onset refractory hypotony following trabeculectomy.

Synopsis:
A 64-year-old male patient diagnosed with primary open angle glaucoma in the right eye underwent combined surgery. Three weeks later, he presented with hypotony which responded well with medical management and then he was lost to follow-up. Two years later, he presented with severe hypotony with shallow choroidal detachment in the right eye, which failed to respond to medical management. Compression sutures were placed over the bleb which also failed to work. Subsequently bleb repair was done with corneal patch graft, which helped resolve the bleb leak, with an improvement in visual acuity and intraocular pressure.

Highlights:
This video highlights the importance of prompt and timely intervention of an overfiltering bleb in preventing irreversible visual loss. Video link: https://youtu.be/8DrxzqQ4qP4
Modified scleral band buckle placement technique
Authors: Bhat Parvez Ahmad , Unnisa Arsalan 
Published: February 2022

Background:
Scleral buckling is considered an art, which has a long learning curve compared to other surgical retina techniques. Unfortunately, this beautiful surgical technique is getting less attention as new retina surgeons don’t get much exposure to this age-old surgical technique, reason being less interest shown by young retina surgeons and tremendous advancement in micro-incision vitrectomy system.This video is a modification of the present technique of placement of band buckle, which uses science rather than art.The most important aspect in band buckle is getting the optimal buckle height which needs a lot of experience before one can achieve it. Most of the surgeons tend to tighten it more than needed that can lead to complications. This new technique is easy to learn and will give controlled reproducible buckle height and can be done safely by the trainees.

Purpose:
The aim of this video is to simplify the technique of scleral buckling which can produce controlled and reproducible buckle height and will reduce the complications associated with a tight band buckle.

Synopsis:
A 360-degree peritomy is made. Four recti muscles are identified and separated and traction sutures are passed under their insertions. A partial thickness scleral tunnel is made in all four quadrants. A silicone band (style#41 used in this video) is passed through the scleral tunnel and under the insertion of all four recti.The two ends of the silicone band are trimmed so that they are opposed to each other. Then a 12-mm strip is cut off from one end, and the two remaining ends are tied with a 5-0 nonabsorbable suture. This technique ensures a 2-mm optimal buckle height.

Highlights:
We present an elegant technique of placing the band buckle in retinal detachment surgery. Video link: https://youtu.be/9_dh6qsd-7A
A comparative analysis of topical corticosteroids and non-steroidal anti-inflammatory drugs to control inflammation and macular edema following uneventful phacoemulsification
Authors: Singhal Deepali , Nanda Ashok , Kanungo Sanghamitra , Sahoo Kalyani , Mohapatra Santosh 
Published: February 2022

Purpose:
To compare the efficacy of topical nonsteroidal anti-inflammatory drugs (NSAIDs) and prednisolone acetate in controlling inflammation and preventing cystoid macular edema (CME) after uneventful phacoemulsification.

Methods:
All patients who underwent uneventful phacoemulsification from December 2020 to Feb 2021 were included in the study. These were randomly assigned to receive any one anti-inflammatory agent among topical nepafenac (0.1%) [96 eyes], bromfenac (0.07%) [93 eyes], preservative-free ketorolac (0.4%) [94 eyes], nepafenac (0.3%) [96 eyes], or prednisolone acetate (1%) [91 eyes]. The efficacy of the drugs was evaluated by comparing the grade of anterior chamber (AC) cells, conjunctival hyperemia, pain score, visual acuity, intraocular pressure (IOP), and central macular thickness (CMT) at 1 and 6 weeks after surgery.

Results:
At 1 and 6 weeks, there was no significant difference in pain score, conjunctival hyperemia, AC cells, change in IOP, and visual acuity between the prednisolone and the NSAIDs groups, though nepafenac 0.3% was most effective. At 6 weeks, there was no significant difference in the number of patients developing subclinical CME in the prednisolone versus NSAID group. The mean increase in CMT was significantly lower in nepafenac 0.3% than prednisolone at 1 and 6 weeks (P = 0.003 and 0.004, respectively).

Conclusion:
NSAIDs used in isolation are comparable to prednisolone in preventing inflammation and pain after uneventful phacoemulsification. However, nepafenac 0.3% is most comparable to prednisolone and more efficacious in reducing the incidence of CME. We recommend that nepafenac 0.3% can be used as a sole anti-inflammatory agent in patients with uneventful phacoemulsification.
Orbital magnetic resonance imaging profile and clinicoradiological correlation in COVID-19-associated rhino-orbital-cerebral mucormycosis: A single-center study of 270 patients from North India
Authors: Hada Maya , Gupta Parul , Bagarhatta Meenu , Tripathy Koushik , Harsh Anita , Khilnani Kamlesh , Mendiratta Kuldeep , Agarwal Sunita , Chouhan Jugal Kishore , Bhandari Sudhir 
Published: February 2022

Purpose:
To study the clinical profile and magnetic resonance imaging (MRI) features in patients of COVID-19-associated rhino-orbital-cerebral mucormycosis (CA-ROCM) with orbital involvement and perform a clinicoradiological correlation.

Methods:
A cross-sectional study was performed at a tertiary care center in north India from May 2021 to June 2021. Consecutive patients with clinical, nasal endoscopic, and/or microbiological evidence of CA-ROCM underwent MRI of paranasal sinuses, orbit, and brain as per the study protocol. Orbital MRI findings were studied in detail and were correlated with clinical signs.

Results:
Two hundred and seventy patients were studied. The mean age was 48.4 (± 16.82) years. A male predilection was noted (male:female = 1.77). Orbital involvement was seen in 146 (54%) patients on clinical evaluation and in 184 (68%) patients on MRI. Unilateral orbital involvement was more common (134; 92%). The most common presenting symptom was periorbital and/or facial pain (141; 52.2%) and the most common clinical sign was periorbital edema (116; 43%). The most common MRI finding was suggestive of orbital cellulitis (160; 59%). Orbital compartment syndrome was found in 17 (6.3%) patients. The inter-rater agreement between clinical and radiological assessments to detect the involvement of infraorbital nerve and frontal nerve was found to be 85.56%, (κ 0.621) and 93.70% (κ 0.776), respectively. The diagnostic accuracy, sensitivity, and specificity of MRI to detect medial orbital wall defect were found to be 87.9%, 65%, and 97%, respectively.

Conclusion:
Orbital imaging features of a cohort of ROCM patients have been presented with clinicoradiological correlation.
Impact of moderate and severe primary open-angle glaucoma on quality of life due to activity limitation
Authors: Nayyar Shifali , Kumar Suresh , Rehman Obaidur , Ichhpujani Parul , Singla Ekta 
Published: February 2022

Purpose:
To study the impact of moderate and severe primary open-angle glaucoma (POAG) on the quality of life (QoL) due to activity limitation using glaucoma-specific questionnaires.

Methods:
This cross-sectional study enrolled 122 participants, 50% (n = 61) being controls and 50% were diagnosed cases of moderate/severe POAG. Three orally administered glaucoma-specific QoL instruments were used: Glaucoma Activity Limitation (GAL-9), Glaucoma Quality of Life (GQL-15), and Viswanathan questionnaires. The questions related to activity limitation were identified and analyzed for each questionnaire separately.

Results:
The mean age of the participants was 61.04 ± 9.88 years and a majority were males (64.8%, n = 79). The mean scores in controls, moderate glaucoma, and severe POAG patients for GAL-9 questionnaire were 9.77 ± 1.36 (P = 0.44), 13.75 ± 4.76 (P < 0.001), and 23.45 ± 5.62 (P < 0.001), for GQL-15, these were 16.39 ± 2.18 (P = 0.5), 22.75 ± 7.89 (P < 0.001), and 39.34 ± 9.42 (P < 0.001), respectively, while for the Viswanathan questionnaire, they were 9.49 ± 0.94 (P = 0.38), 7.91 ± 1.59 (P < 0.001), and 4.41 ± 2.20 (P < 0.001), respectively. The GQL-15 and GAL-9 questionnaires concluded that activity limitation pertaining to dark adaptation-related tasks affected the QoL the most in moderate as well as severe POAG (P < 0.001). Using the Viswanathan questionnaire, it was observed that the peripheral vision-related activity limitation was most significant for the decrease in QoL in moderate POAG while near vision-related activity limitation affected the QoL the most in severe POAG (P < 0.001).

Conclusion:
All three questionnaires concluded that the activity limitation due to moderate and severe glaucoma has a negative impact on the QoL. The limitation of the tasks involving dark adaptation/glare and peripheral vision has the most significant impact on the QoL in moderate glaucoma. As the disease progresses to a severe category, the limitation of activities requiring central and near vision causes the most significant worsening in QoL.
Ocular signs, visual and general developmental outcome in Indian children with radiologically proven periventricular leukomalacia
Authors: Vijayalakshmi Perumalsamy , Flora Jeyaseeli , Shah Gargi , Sahithya Bhaskaran , Gilbert Clare 
Published: February 2022

Purpose:
Owing to the paucity of literature on Indian children with periventricular leukomalacia (PVL), this retrospective study aimed to describe the visual and associated developmental abnormalities in a series of affected children attending a tertiary level eye care facility.

Methods:
Children with radiologically confirmed PVL who attended the Pediatric Department of a tertiary eye hospital were included and underwent a detailed ocular and general developmental assessment.

Results:
Of the 75 children, the mean age was 2.3 years, the mean follow-up was 3.1 years, 68% were males and 43% were born preterm. Grade I PVL was identified in 13 children (17%), Grade 2 PVL in 39 (52%), and Grade 3 PVL in 23 (31%). Premies with ≤2 kg (72.5%) and term babies with >2 kg (75%) had a greater association of PVL occurrence with a preponderance to severe PVL; 46% of the children were visually impaired which was significantly higher in the children with Grade 3 PVL (74%) than those with Grade 2 PVL (15%). Strabismus was common (80%) with a change in deviation over time. Seventy-one percent of the children had a refractive error, frequently myopic astigmatism. All the children except two had a delay in one or more general developmental milestones.

Conclusion:
PVL occurrence is observed both in the babies born at term and premies, resulting in significant ocular and systemic morbidities. We recommend a system in place for early identification and referral to initiate an early intervention program which goes a long way toward improving the quality of life in these children.
Occurrence of vernal keratoconjunctivitis in children infected with human immunodeficiency virus
Authors: Une Vaishali L , Jadhav Sourabh M 
Published: February 2022

Purpose:
To study the occurrence of vernal keratoconjunctivitis (VKC) as an ocular manifestation of human immunodeficiency virus (HIV) in pediatric patients.

Methods:
A retrospective study was done on the observations of cases of HIV-positive children. All seropositive patients from the Anti-Retroviral Therapy clinic were referred to the department of ophthalmology for evaluation. Retrospective correlation of CD4 count with active cases of VKC was done. All patients underwent a comprehensive ophthalmic evaluation including visual acuity, slit lamp and dilated fundus examination.

Results:
A total of 72 children were included, 70 males and 2 females. Of these, 63 (87.5%) had VKC, three (4.2%) had cataract, two (2.8%) had cytomegalovirus retinitis retinitis, and four (5.5%) had no ophthalmic findings.

Conclusion:
There is a an evident association of HIV, VKC cases, and reduced CD4 count. More research is required on this topic.
Biofilm formation and its effect on the management of culture-positive bacterial endophthalmitis
Authors: Lodha Dimple , Karolia Roshni , Sharma Savitri , Joseph Joveeta , Das Taraprasad , Dave Vivek P 
Published: February 2022

Purpose:
To compare the clinicomicrobiological features and outcomes in patients with infectious endophthalmitis caused by biofilm-positive (BP) and biofilm-negative (BN) bacteria.

Methods:
This was a prospective, interventional, comparative, nonrandomized, consecutive case series. Culture-positive bacterial endophthalmitis cases from August 1, 2018 to July 31st 31, 2019 were included. All vitreous samples were tested for biofilm using crystal violet plate and XTT (2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) methods and classified as BN and BP. The antibiotic susceptibility of all organisms was determined. Anatomic and functional success was defined as intraocular pressure >5 mm Hg and final best-corrected vision ≥20/400, respectively, at last visit.

Results:
There were 50 eyes in the BN group and 33 eyes in the BP group. BN group eyes required 2.86 ± 1.45 surgical interventions, and BP group eyes needed surgical 6.36 ± 2.89 interventions, P < 0.0001, 95% Confidence Interval, CI: 2–4. Median follow-up was 6 and 5 months, respectively (P = 0.33). Final logMAR vision was a median of 1.2 and 1.9 respectively; P = 0.0005, 95% C.I.: 0.4–1.7. Functional success was achieved in 44% and 21.2% (P = 0.03, 95% C.I.: 1.86%–40.08%) and anatomic success was achieved in 68% and 42.42%, respectively (P = 0.02, 95% C.I.: 3.85%–45.47%). The antimicrobial resistance patterns between the two groups were comparable.

Conclusion:
Endophthalmitis caused by the biofilm-forming bacteria needs a greater number of surgical interventions. The anatomic and functional outcomes are poorer than non-biofilm-forming bacterial endophthalmitis. The increased virulence and poorer outcomes can be hypothesized to be due to the physical barrier effect of the biofilm on the antibiotics.
Visual impairment and blindness among children from schools for the blind in Maharashtra state, India: Changing trends over the last decade
Authors: Kulkarni Sucheta , Gilbert Clare , Giri Nilesh , Hankare Pravin , Dole Kuldeep , Deshpande M 
Published: February 2022

Purpose:
To determine the causes of severe visual impairment and blindness in children in schools for the blind in Maharashtra, India.

Methods:
Children aged <16 years, enrolled in the schools for the blind in Maharashtra state, India were examined between October 2018 and December 2019. The anatomical sites and etiology for blindness were recorded using the World Health Organization’s standard reporting form. Causes of blindness were compared among different regions of the state and also by different age groups.

Results:
Of the 1,969 students examined from 39 schools for the blind, 188 children (9.5%) had severe visual impairment and 1,666 children (84.6%) were blind. Whole globe anomalies (794, 42.8%) were the most common anatomical site of vision loss in children, followed by corneal (289, 15.6%) and retinal abnormalities (280, 15.2%). Corneal causes were second most common in the poorer districts of Vidarbha (15.3%) and Marathwada (14.6%), whereas retinal causes were second most common in the wealthier regions of western Maharashtra (18.3%) and Khandesh (24.1%). Nearly one-third (593, 32%) of children were blind from potentially avoidable causes. Preventable blindness consisting of corneal causes and retinopathy of prematurity was seen in 281 (15.2%) cases, whereas treatable causes comprising of lens-related causes, glaucomas, refractive errors, amblyopia, and uveitis accounted for another 311 (16.8%). Among the younger children (≤10 years), the proportion of corneal blindness was lower (83/623, 13.3% vs. 206/1232, 16.7%) and that of retinal blindness was higher (119/623, 19% vs. 163/1232, 13.2%) than the older children.

Conclusion:
Whole globe anomalies constitute a major cause of SVI and blindness in Maharashtra. There seems to be an increase in the proportion of retinal blindness, especially retinopathy of prematurity, suggesting a need for increased screening coverage.