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Parihar JKS, Parihar AKS, Kaushik J, Singh A. How to maintain equilibrium between the quantum and quality of cataract surgery training and patient safety measures. Indian J Ophthalmol 2024; 72:134-135. [PMID: 38131586 PMCID: PMC10841802 DOI: 10.4103/ijo.ijo_1847_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
| | | | - Jaya Kaushik
- Department of Ophthalmology, Command Hospital (CC), Lucknow, Uttar Pradesh, India
| | - Ankita Singh
- Department of Ophthalmology, Military Hospital, Bathinda, Punjab, India
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Moosa M, Kaushik J, Singh A. Clinical evaluation of ophthalmic findings in active, amateur, adult, competitive male boxers in India. Rom J Ophthalmol 2024; 68:25-30. [PMID: 38617717 PMCID: PMC11007561 DOI: 10.22336/rjo.2024.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/16/2024] Open
Abstract
Background: In the popular fighting sport of boxing, opponents strike each other above the belt line in the face, chest, and belly. The physical parts most exposed are therefore the nose and eyes. In amateur boxing, fights go only three rounds - three minutes for men and one minute for women - with a one-minute break in between. They wear gloves, but the head protection used in the men's game has been removed by AIBA due to the high likelihood of concussion when using head protection. Because chronic ocular changes may take longer than the expected short-term effects, this study included at least 3 years of competitive sports participation. Study design and setting: Institutional-based cross-sectional study. Materials and methods: To evaluate ophthalmic outcomes, 200 eyes of 100 active amateur, adult, and competitive male boxers were studied. Results: Of the 100 boxers, 51 had ophthalmic changes in at least one eye, and 49 had normal eyes. The average age of boxers was 24.98 years. The average duration of boxing training was 7.04 years. Healed eyelid scars, subconjunctival hemorrhages, conjunctival papillae, traumatic mydriasis, posterior synechiae, angulation abnormalities, traumatic cataracts, lens subluxation, increased intraocular pressure, and peripapillary atrophy were observed on the ocular side. None of these could be attributed to boxing. Conclusion: Boxing-related eye injuries are common in India and the most common vision-threatening eye abnormalities include traumatic cataracts, lens subluxation, and angle abnormalities. Surprisingly, no macular lesions were found on physical examination and OCT. Additional studies with a larger number of boxers will be needed to evaluate and prevent clinical symptoms. All boxers should have a complete eye exam regularly. Abbreviations: AIBA = Association Internationale de Boxe Amateur, OCT = Optical Coherence Tomography.
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Affiliation(s)
| | - Jaya Kaushik
- Department of Ophthalmology, CH Lucknow, Uttar Pradesh, India
| | - Ankita Singh
- Department of Ophthalmology, Military Hospital Bathinda, Punjab, India
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Chaturvedi P, Kaushik J, Mathur V, Kumar P, Chauhan N. Determining the effect of climate and profession on dry eye disease: A prevalence study among young males in north, north-west and central India. Med J Armed Forces India 2023; 79:S75-S83. [PMID: 38144639 PMCID: PMC10746808 DOI: 10.1016/j.mjafi.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 12/28/2021] [Indexed: 10/18/2022] Open
Abstract
Background Ocular tear film and the ocular surface together represent a dynamic playground of various protective factors against environmental influencers. Surrounding environment and geoclimatic milieu are the pertinent and continuous influencing factors. Prevalence study of Dry eye disease (DED) in various climatic conditions and professions provides an insight into this peculiar aspect of DED and human geography. Methods This was a hospital based, cross-sectional, comparative, analytical observational study. 1840 young soldiers between 25 and 45 years of age were studied. Divided in five climate groups based on Köppen-Geiger climate classification system the subjects were sub-grouped into professions exposed to known aggravating environmental factors. The ocular surface was examined for signs and symptoms of DED and its prevalence and risk ratio for different climates and professions were calculated. Results Highest prevalence of DED was found in cold desert climate and among visual display unit (VDU) users. Least prevalence was seen in highland type of climate and among people involved in professional exposed to high temperature. Prevalence of DED based upon the signs and ocular surface disease index (OSDI) was calculated and stratified with risk ratio for climatic conditions and professions. Conclusion Different climatic conditions and professions had different prevalence of signs, symptoms of OSD and DED which indicated its influence on prevalence of the disease.
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Affiliation(s)
- P.K. Chaturvedi
- Associate Professor (Ophthalmology), Base Hospital, Delhi Cantt, India
| | - Jaya Kaushik
- Professor, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Vijay Mathur
- Consultant & Professor (Ophthalmology), Command Hospital (Northern Command), Udhampur, India
| | - Pradeep Kumar
- Associate Professor (Ophthalmology), Army Hospital (Research & Referral), New Delhi, India
| | - Neha Chauhan
- Resident (Ophthalmlogy), Command Hospital (Western Command), Chandimandir, India
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Kaushik J, Bhatta S, Singh A, Jha R. Assessing the Competence of Artificial Intelligence Programs in Pediatric Ophthalmology and Strabismus and Comparing their Relative Advantages. Rom J Ophthalmol 2023; 67:389-393. [PMID: 38239420 PMCID: PMC10793362 DOI: 10.22336/rjo.2023.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 01/22/2024] Open
Abstract
Objective: The aim of the study was to determine the knowledge levels of ChatGPT, Bing, and Bard artificial intelligence programs produced by three different manufacturers regarding pediatric ophthalmology and strabismus and to compare their strengths and weaknesses. Methods: Forty-four questions testing the knowledge levels of pediatric ophthalmology and strabismus were asked in ChatGPT, Bing, and Bard artificial intelligence programs. Questions were grouped as correct or incorrect. The accuracy rates were statistically compared. Results: ChatGPT chatbot gave 59.1% correct answers, Bing chatbot gave 70.5% correct answers, and Bard chatbot gave 72.7% correct answers to the questions asked. No significant difference was observed between the rates of correct answers to the questions in all 3 artificial intelligence programs (p=0.343, Pearson's chi-square test). Conclusion: Although information about pediatric ophthalmology and strabismus can be accessed using current artificial intelligence programs, the answers given may not always be accurate. Care should always be taken when evaluating this information.
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Affiliation(s)
- Jaya Kaushik
- Department of Ophthalmology, Command Hospital (Lucknow), U.P, India
| | - Sunandan Bhatta
- Department of Ophthalmology, Military Hospital (Agra), U.P, India
| | - Ankita Singh
- Department of Ophthalmology, Military Hospital (Bathinda), Punjab, India
| | - Rakesh Jha
- Department of Ophthalmology, Command Hospital (Lucknow), U.P, India
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Kaushik J, Singh A, Bhatta S, Goyal S, Parihar JKS. Posterior keratometry changes after steep axis phacoemulsification: a prospective study. Rom J Ophthalmol 2023; 67:275-282. [PMID: 37876511 PMCID: PMC10591432 DOI: 10.22336/rjo.2023.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 10/26/2023] Open
Abstract
Purpose: To measure changes in posterior corneal curvature after steep axis phacoemulsification and investigate the possibility of its effect on SIA. Methods: This was a prospective longitudinal study on 60 consecutive eyes of age-related cataract with regular astigmatism and absence of co-morbidities undergoing uneventful cataract surgeries with main incision at steep meridian. Preoperative and 4 weeks postoperative measurements of anterior and posterior corneal curvatures using Scheimpflug based corneal topographer were performed. Posterior corneal curvature was assessed at 3, 5- and 7-mm diameters. Results: The study found a statistically significant change in posterior corneal K1, K2 and mean astigmatism in all zones (3, 5 and 7 mm) at 4 weeks postoperative, when compared to preoperative readings. Conclusion: Posterior keratometry is likely to be an important determinant of Surgically Induced Astigmatism (SIA) and should be factored in for refractive cataract surgery.
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Affiliation(s)
- Jaya Kaushik
- Department of Ophthalmology, Command Hospital (Lucknow), U.P, India
| | - Ankita Singh
- Department of Ophthalmology, Military Hospital (Bathinda), Punjab, India
| | - Sunandan Bhatta
- Department of Ophthalmology, Military Hospital (Agra), U.P, India
| | - Sumit Goyal
- Department of Ophthalmology, Military Hospital (Bareilly), U.P, India
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Parihar JK, Kaushik J, Singh A. Commentary: Demystifying the need of stringent visual standards for military duties. Indian J Ophthalmol 2023; 71:2216-2217. [PMID: 37202952 PMCID: PMC10391449 DOI: 10.4103/ijo.ijo_3319_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- J Ks Parihar
- Ophthalmology, Centre for Sight, New Delhi, India
| | - Jaya Kaushik
- Ophthalmology, Command Hospital (CC), Lucknow, Uttar Pradesh, India
| | - Ankita Singh
- Graded Specialist, 174 Military Hospital, Bathinda, Punjab, India
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Agrawal M, Singhal A, Kumar P, Vats S, Kaushik J, Srujana D, Yadav A. Pattern and distribution of neovascularization in proliferative diabetic retinopathy on fundus fluorescein angiography: A growing paradigm. Med J Armed Forces India 2023; 79:207-212. [PMID: 36969113 PMCID: PMC10037048 DOI: 10.1016/j.mjafi.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 02/11/2021] [Indexed: 11/29/2022] Open
Abstract
Background The objective of this study was to evaluate pattern and distribution of neovascularization of optic disc (NVD) and elsewhere (NVE) in proliferative diabetic retinopathy (PDR). Methods A cross-sectional study was conducted among freshly detected cases of PDR. Fundus fluorescein angiographic images of 61 eyes were assessed. Parameters studied for NVD were their number and location and for NVE were their number, location, type of leak, and distance from center of optic disc. Results Of 61 eyes, 29 eyes (47.5%) had NVD with a total of 49 leaks. Of these 49 NVD leaks, the maximum was concentrated in the superotemporal quadrant with 21 leaks (42.9%; 95%CI 28.8-57.8%). Of 61 eyes, 50 eyes (82%) had NVE with 97 leaks. Of 97 NVE leaks, 41 were found in the superotemporal quadrant (42.3%; 95%CI 32.3-52.7%). Maximum NVE was found within the circle of radius 3-6 mm centered on optic disc (p value = 0.001) with no leaks in central macula. Of 29 eyes with NVD, only 7 eyes had >1/3 area of disc involvement. Also, of 18 eyes with concurrent NVD and NVE, only 2 eyes had >1/3 area of disc involvement which is a high-risk characteristic of PDR. Conclusion Neovascular lesions have a predilection for superotemporal part for both NVD and NVE. NVE leaks were almost double the number of NVD leaks. Maximum NVE leaks were found at posterior pole with no central macular involvement. This study provides comprehensive data and further adds to knowledge of neovascularization for early diagnosis and management of PDR.
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Affiliation(s)
- Mohini Agrawal
- Resident, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Aanchal Singhal
- Resident, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Poninder Kumar
- Professor & Head, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Sumedha Vats
- Senior Resident, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Jaya Kaushik
- Associate Professor, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - D. Srujana
- Associate Professor, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Arun Yadav
- Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune, India
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Kumar A, Shankar S, Arora A, Bhanot R, Gupta A, Ambiya V, Kaushik J, D S. Association of serum vitamin D levels with clinical spectrum of central serous chorioretinopathy patients of Indian origin. Photodiagnosis Photodyn Ther 2023; 41:103281. [PMID: 36627071 DOI: 10.1016/j.pdpdt.2023.103281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 12/30/2022] [Accepted: 01/06/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Vitamin D, a fat-soluble prohormone has been implicated in various ophthalmological diseases such as ocular inflammation, glaucoma, diabetic retinopathy and ocular angiogenesis. Many studies have shown effect of vitamin D on oxidative stress, angiogenesis and retinal circulation. However, there is definitive lack in published literature on effect of vitamin D on central serous chorioretinopathy especially in view of various epidemiological studies reporting risk of vitamin deficiency in up to 40% adult population. OBJECTIVE To determine serum vitamin D levels in various clinical profiles of central serous chorioretinopathy and their effect on its pathophysiology in Indian population. DESIGN Case control observational study METHODS: Study included 42 patients (group P) of central serous chorioretinopathy (CSCR) diagnosed with optic coherence tomography (OCT), fundus fluorescein angiography (FFA) which were further sub-grouped into acute(P1), chronic (P2) and recurrent (P3). A total of 44 age & sex-matched healthy control subjects (group C) were also included. The vitamin D levels of both groups were examined and analyzed. RESULTS No significant difference between the groups P and C in respect of age, gender or baseline best corrected visual acuity (P = 0.153, P = 0.123 and P = 0.08, respectively) was noted. Vitamin D levels were determined as 16.473 ± 7.307 ng/mL in group P and 34.940 ± 8.348 ng/mL in group C and difference was statistically significant(P = 0.001). There were statistically significantly more no of patient in group P (78.57%) with deficient vitamin D levels as compared to normal serum levels (4.76%) (P = 0.04). Patients in group P1(acute CSCR) and P2(Chronic CSCR) also had significant more no of subjects with deficient vitamin D levels as compared to normal serum levels (P = 0.01 and P = 0.03). CONCLUSIONS The low serum vitamin D levels were determined in all clinical sub-types of central serous chorioretinopathy patients which point to its possible role in the pathophysiology of the disease. There is a need for further studies to determine the changes that could occur with vitamin replacement therapy in CSCR.
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Affiliation(s)
- Ashok Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India.
| | - Sandeep Shankar
- Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - Amit Arora
- Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - Rohit Bhanot
- Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - Arun Gupta
- Department of Community Medicine, Armed Forces Medical College, Pune 411040, India
| | - Vikas Ambiya
- Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - Srujana D
- Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
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Krishna Chaitanya YV, Shyamsundar K, Kumar P, Kaushik J, Agrawal M, Moosa M. Posterior lens capsular neovascularization in the absence of any risk factors. J Clin Ophthalmol Res 2023. [DOI: 10.4103/jcor.jcor_90_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Singh B, Kumar P, Moulick P, Shankar S, Kaushik J, Sati A. Comparison of changes in blood pressure in phacoemulsification cataract surgery performed via topical and peribulbar anaesthesia: A cohort study. Med J Armed Forces India 2023; 79:34-39. [PMID: 36605347 PMCID: PMC9807736 DOI: 10.1016/j.mjafi.2020.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 12/21/2020] [Indexed: 02/01/2023] Open
Abstract
Background The purpose of study was to compare the changes in blood pressure in patients undergoing phacoemulsification cataract surgery under topical and peribulbar anaesthesia during preoperative, intraoperative and postoperative period. Methods In this prospective cohort study, 240 patients undergoing phacoemulsification were divided into topical (Group 1) and peribulbar (Group 2) equally. Proparacaine 0.5% drops were used for topical anaesthesia, and Inj lignocaine with Inj bupivacaine were used to give peribulbar anaesthesia. Preoperative blood pressure was taken 30 min before surgery with automated sphygmomanometer. Intraoperative blood pressure was taken during phacoemulsification, and postoperative blood pressure was taken 1 h after surgery. Outcomes assessed were systolic, diastolic and mean blood pressure. Results Systolic blood pressure in Group 1 was significantly increased in the intraoperative phase, whereas it was significantly decreased in Group 2 in the intraoperative phase. Diastolic and mean blood pressure in Group 1 showed no significant change, whereas in Group 2, both showed significant reduction in intraoperative and postoperative phases. Conclusion The increase in intraoperative systolic blood pressure in topical group could be due to discomfort from microscope light, iris manipulation, irrigation and aspiration during surgery. The decrease in intraoperative systolic and diastolic blood pressure in peribulbar group could be due to systemic absorption of local anaesthetic. The mean preoperative systolic blood pressure was also higher in the topical group, which could be due to anxiety or stress under topical anaesthesia. The changes in blood pressure need to be observed so that timely intervention can be made to achieve favourable postoperative outcome.
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Affiliation(s)
| | - Poninder Kumar
- Professor & Head, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - P.S. Moulick
- Consultant (Ophthalmology), Apollo Hospital, Kolkata, India
| | | | - Jaya Kaushik
- Associate Professor, Dept of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Alok Sati
- Associate Professor (Ophthalmology), Army Hospital (R & R), Delhi Cantt, India
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Kaushik J, Riyaz E, Chaitanya YVK, Nair R, Kumar A, Singh A, Parihar JKS, Srikant S, Shetty R. An insight into the altered ophthalmic dynamics during the COVID-19 pandemic. Indian J Ophthalmol 2022; 70:3643-3648. [PMID: 36190064 PMCID: PMC9789823 DOI: 10.4103/ijo.ijo_254_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose The objective of this survey-based study was to examine the effects of personal protective measures taken at the level of instrument and surgeon during the pandemic on the optics in ophthalmology. Methods The study involved an online questionnaire of 24 questions which was distributed to ophthalmologists practicing in several hospitals, including residents and fellows undergoing training in ophthalmology in India. The responses were collected through an online data collection tool (Google forms). The participants could choose from multiple options provided to them in each question. Results A total of 285 participants out of 296 had used modified methods for examining and performing surgical procedures during the pandemic, while 78.7% (265) of the participants acknowledged having encountered difficulty in interpreting the ocular findings of patients while examining in personal protective equipment. Moreover, 58.7% (198) of our study respondents also reported that there was significant worsening of the quality of ophthalmological examination with pandemic-appropriate measures and 84.8% (286) of our study participants also felt that these measures have significantly added to the time of examination, hence increasing the risk of exposure to both patient and doctor. Conclusion The workplace study has highlighted the crucial aspects of optics in ophthalmology during the pandemic. The protective measures taken during the pandemic have significantly worsened the quality of ophthalmological examination and increased the time taken to perform outpatient department-based and surgical procedures in ophthalmology.
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Affiliation(s)
- Jaya Kaushik
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India,Correspondence to: Dr. Jaya Kaushik, Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra - 411 040, India. E-mail:
| | - Eram Riyaz
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - YVK Chaitanya
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Renu Nair
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ashok Kumar
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ankita Singh
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - JKS Parihar
- Department of Ophthalmology and Post Graduate Training and Education, Centre for Sight, New Delhi, India
| | - S Srikant
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Rakesh Shetty
- Department of Ophthalmology, Golden Jublee Block, Armed Forces Medical College, Pune, Maharashtra, India
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Pandey S, Sati A, Kumar P, Kaushik J. Bilateral cranial nerve involvement with facial asymmetry in a case of goldenhar syndrome. Med J Armed Forces India 2022; 78:S296-S299. [PMID: 36147415 PMCID: PMC9485750 DOI: 10.1016/j.mjafi.2020.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 05/18/2020] [Indexed: 11/22/2022] Open
Abstract
A 9-year-old male patient presented with recurrent episodes of corneal ulcers in both eyes since the age of 2 years. The patient had profound bilateral hearing loss and multiple left-sided preauricular skin tags. He was diagnosed with neurotropic keratitis with bilateral corneal anesthesia in both eyes and on further work-up was diagnosed to have Goldenhar Syndrome with features of left-sided facial skeletal hypoplasia and bilateral auditory nerve atresia. The patient was managed by multiple specialities with standard of care medications, therapies, and procedures and is presently thriving. Goldenhar syndrome is a rare congenital disorder which involves ocular, auricular, and cranial nerves along with facial and vertebral anomalies. The insufficient knowledge of its pathogenesis and variable clinical presentations present a challenge in timely diagnosis and management of these cases. The involvement is generally unilateral and unilateral skeletal asymmetry with bilateral cranial nerve involvement is a rare event. The wide variation in clinical presentation and under diagnosis of these cases in India mandates a better understanding of this entity among medical professionals to facilitate early diagnosis and favorable clinical outcomes.
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Affiliation(s)
- Shikha Pandey
- Resident, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Alok Sati
- Professor (Ophthalmology), Army Hospital (R&R), New Delhi, India
| | - Poninder Kumar
- Professor & Head, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Jaya Kaushik
- Professor, Department of Ophthalmology, Armed Forces Medical College, Pune, India
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Singh A, Kumar P, Sinha P, Kaushik J, Srujana D, Shetty R, Kochhar D, Tripathy DM. An observational study on ocular manifestations in patients of psoriasis in a tertiary care hospital in western India. Med J Armed Forces India 2022; 78:S186-S193. [PMID: 36147389 PMCID: PMC9485855 DOI: 10.1016/j.mjafi.2020.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/23/2020] [Indexed: 11/17/2022] Open
Abstract
Background The aim of the study is to observe the ocular manifestation in patients of psoriasis. Methods All the diagnosed cases of Psoriasis by the dermatology department of this tertiary care hospital were included in this study. Relevant details of the history pertaining to disease duration, type of psoriasis, and treatment undertaken including ocular symptoms were obtained. Disease severity was quantified using the PASI score. Complete ocular examination including intraocular pressure, Schirmer I and II tests, Tear Film Breakup Tme (TBUT); was carried out for all the patients. Results Of 126 patients of psoriasis, ocular manifestations were seen in 76 patients (60.3%). Dry eyes (27%) and blepharitis (15.9%) were the most common ocular manifestations. Uveitis was seen in 3.2% of the patients of which 75% patients were HA B27-positive psoriatic arthritis, which was statistically significant (p = 0.001). There was no statistical correlation between duration of the disease and ocular manifestations (p value is 0.077 using chi square test). The ocular manifestations were more common in patients with PASI score 10 when compared with the patients with PASI score 10 (p value = 0.028) which was statistically significant. Conclusions In our study, prevalence of ocular manifestation was 60.3% which increased with the increasing PASI score. Dry eyes and blepharitis were the most common manifestations. Hence, routine ocular examination is recommended in patients with psoriasis.
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Affiliation(s)
- Ankita Singh
- Resident, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Poninder Kumar
- Professor & Head, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Preema Sinha
- Professor & Head (Dermatology), Base Hospital, Lucknow, India
| | - Jaya Kaushik
- Professor, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - D. Srujana
- Associate Professor, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Rakesh Shetty
- Resident, Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Divya Kochhar
- Resident, Department of Ophthalmology, Armed Forces Medical College, Pune, India
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Shetty R, Kaushik J, Kumar A, Singh A. Clinical study to estimate correlation between graft thickness as measured by anterior segment Optical Coherence Tomography and visual recovery after manual Descemet stripping endothelial keratoplasty. Rom J Ophthalmol 2022; 66:118-124. [PMID: 35935088 PMCID: PMC9289763 DOI: 10.22336/rjo.2022.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose: To estimate the correlation between graft thickness as measured by anterior segment Optical Coherence Tomography and visual recovery after manual Descemet stripping endothelial keratoplasty. Design: Prospective observational study. Materials and methods: This prospective observational study included 25 patients with pseudophakic bullous keratopathy, who underwent DSEK. Visual acuity in LogMAR units and estimation of graft thickness measured by Anterior Segment Optical Coherence Tomography (AS-OCT) was carried out on postoperative day 1, 3rd month and 6th month. Correlation analysis was performed between graft thickness and postoperative visual acuity on postoperative day 1, 3rd month and 6th month. Results: The mean LogMAR visual acuity improved in all patients post DSEK - 1.47 (±0.48) to 0.75 (±0.38) LogMAR units. The average postoperative day 1 central corneal thickness was 724.96 µm (±77.59 µm), which decreased to mean central corneal thickness of 655.56 (±61.08 µm) on 3rd month and 633.48 (58.72) by the 6th month. Mean donor graft thickness on postoperative day 1, 3rd month and 6th month in this study was found to be 169.3 µm (±36.6 µm), 135.9 µm (±29.8 µm) and 127.5 µm (±31 µm) corresponding to a BCVA of 1.94, 0.86 and 0.75 LogMAR units respectively. On correlation analysis, thinner grafts were found to be associated with better postoperative BCVA especially on the 3rd and 6th month follow-up period. Conclusion: This study found that a higher proportion of thinner grafts achieved better postoperative visual rehabilitation and earlier stabilization of visual acuity.
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Affiliation(s)
- Rakesh Shetty
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Arun Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ankita Singh
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
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Kaushik J, Parihar JKS, Shetty R, Singh A, Chaturvedi P. A Long-term Clinical Study to Evaluate AGV with Concurrent Intravitreal Ranibizumab vs Primary AGV Implantation in Cases of Refractory Neovascular Glaucoma. J Curr Glaucoma Pract 2022; 16:41-46. [PMID: 36060043 PMCID: PMC9385393 DOI: 10.5005/jp-journals-10078-1355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Methods Results Conclusion How to cite this article
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Affiliation(s)
- Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College Pune, Maharashtra, India
- Jaya Kaushik, Department of Ophthalmology, Armed Forces Medical College Pune, Maharashtra, India, Phone: +91 8390010094, e-mail:
| | | | - Rakesh Shetty
- Department of Ophthalmology, Armed Forces Medical College Pune, Maharashtra, India
| | - Ankita Singh
- Department of Ophthalmology, Armed Forces Medical College Pune, Maharashtra, India
| | - Piyush Chaturvedi
- Department of Ophthalmology, Command Hospital, Panchkula, Haryana, India
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Kumar A, Sahu A, Kaushik J, Bhanot R, Arora A. Kyrieleis like plaques - atypical presentation of ocular Behcet’s disease. Rom J Ophthalmol 2022; 65:383-385. [PMID: 35087981 PMCID: PMC8764423 DOI: 10.22336/rjo.2021.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 11/27/2022] Open
Abstract
Purpose: To report an unusual presentation with kyrieleis like plaques in a patient with ocular Behcet’s disease. Case presentation: A 28-year-old young male presented with blurring of vision in the left eye, fundus examination revealing focal segmental intra-arterial plaques involving all branches of retinal artery characteristics of kyrieleis-like plaques with no features of retinitis in retinal periphery and mild vitritis. All routine investigations were normal, the patient testing positive for HLA-B51 marker, diagnosed as a case of ocular Bechet’s disease and managed with oral steroids and immunosuppressive agents. Results: The patient had good recovery of vision with substantial resolution of intra-arterial plaques. Conclusion: Ocular Bechet’s disease can present with uncommon features of kyrieleis like plaques. Ophthalmologists need to be vigilant for the presence of such potential ocular manifestations as the likely initial presentation in order to obtain early diagnosis and initiate timely management.
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Affiliation(s)
| | | | | | | | - Amit Arora
- Department of Ophthalmology, Military Hospital, Kirkee, Pune, India
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Singhal A, Kaushik J, Singh A, Shetty R. Descemet Stripping Endothelial Keratoplasty in Microcornea for Pseudophakic Bullous Keratopathy With Anterior Chamber Intraocular Lens. Cureus 2021; 13:e19262. [PMID: 34900458 PMCID: PMC8648131 DOI: 10.7759/cureus.19262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 11/05/2022] Open
Abstract
To report a case of bilateral pseudophakic bullous keratopathy (PBK) in a patient having bilateral microcornea with pre-existing anterior chamber intraocular lens (ACIOL) who underwent Descemet stripping endothelial keratoplasty (DSEK) with a successful postoperative visual outcome. A 36-year-old female, diagnosed with microcornea and congenital cataract in both eyes underwent lens aspiration sequentially followed by ACIOL implantation in both eyes. The patient reported to our centre and was diagnosed with bilateral PBK with ACIOL with microcornea. She also had associated secondary glaucoma, postoperative chronic uveitis, and hyphaema, which were controlled with medical management first and taken into consideration while planning DSEK. The patient underwent manual DSEK without intraocular lens exchange under local anaesthesia in both eyes sequentially with a good visual recovery postoperatively in both eyes. Descemet stripping automated endothelial keratoplasty (DSAEK)/DSEK seems a viable option in patients with microcornea who develop PBK following cataract surgery with retained ACIOL where there is absence of capsular support as well as deficiency of iris tissue.
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Affiliation(s)
| | - Jaya Kaushik
- Ophthalmology, Armed Forces Medical College, Pune, IND
| | - Ankita Singh
- Ophthalmology, Armed Forces Medical College, Pune, IND
| | - Rakesh Shetty
- Ophthalmology, Armed Forces Medical College, Pune, IND
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18
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Kaushik J, Chaitanya YVK, Kumar A, Jakhar P, Shetty R, Singhal A, Parihar JKS, Singh A. Prevalence and effectiveness of innovative techniques in ophthalmic surgical training during COVID-19 pandemic in India. Indian J Ophthalmol 2021; 69:3704-3708. [PMID: 34827027 PMCID: PMC8837362 DOI: 10.4103/ijo.ijo_1886_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose: This study aimed to determine the various innovative surgical training techniques prevalent among ophthalmology residents in India during the COVID-19 pandemic. Methods: This was a prospective cross-sectional study. An online survey questionnaire was completed by ophthalmology residents from different parts of the country. The survey consisted of questions related to the impact of the pandemic on training, innovative training techniques adapted during the pandemic and their effectiveness, and COVID-19 duty-related information. Results: A total of 147 responses were obtained. The mean age was 29.3 years (range: 24–40 years, SD: ±3.82). Of which, 87 (59.2%) respondents were females. A total of 61 (41.5%) respondents reported practicing steps of ocular surgeries on goat eye, 69 (46.9%) on model eye/vegetables/fruits, 30 (20.4%) on surgical simulators, and 26 (17.7%) utilized 3-D virtual images and videos. In addition, 22 (15%) respondents reported never using any such techniques. Furthermore, 130 (88.4%) respondents reported practicing steps of cataract surgery, 52 (35.4%) practiced steps of open globe repair, and steps of trabeculectomy were reported by 24 (16.3%). The steps that were reported to be practiced most are incision or tunnel construction by 108 (73.5%), suturing by 92 (62.6%), capsulorrhexis by 91 (61.9%), primary wound repair by 82 (55.8%), and conjunctival peritomy by 75 (51%). Conclusion: The present study demonstrates that residents across the country are adapting to the present scenario by utilizing several innovative methods to sharpen their surgical acumen. The current pandemic situation can serve as an impetus to emphasize upon the institutes and medical regulatory bodies to appropriately remodel the residency curriculum.
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Affiliation(s)
- Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Y V K Chaitanya
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ashok Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Pushpendra Jakhar
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Rakesh Shetty
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Aanchal Singhal
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - J K S Parihar
- Department of Ophthalmology and Post Graduate Training and Education, Centre for Sight, New Delhi, India
| | - Ankita Singh
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
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Kaushik J, Singh A, Shetty R, Parihar JKS, Kochhar D, Singhal A. Visual Outcome of Combined Descemet Stripping Endothelial Keratoplasty and Sutured Scleral Fixated Intraocular Lens in Endothelial Decompensation with Coexistent Aphakia or Intra Ocular Lens Subluxation. Ann Natl Acad Med Sci 2021. [DOI: 10.1055/s-0041-1739036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Abstract
Purpose To elucidate visual outcome of patients after combined Descemet stripping endothelial keratoplasty (DSEK) with scleral fixated intra ocular lens (SFIOL) implantation in patients of endothelial decompensation with coexistent aphakia or lens subluxation.
Materials and Methods A prospective interventional study of combined DSEK with sutured SFIOL in the patients who have undergone surgery at our center over 6-month follow-up period. Preoperative visual acuity and slit lamp findings were documented. Postoperative follow-up was done at days 1, 3, and 7 subsequently, months 1 and 3, and thereafter monthly till the sixth month.
Results Mean age of the patients was 60.47 years. Six patients had aphakic bullous keratopathy, while 11 patients had pseudophakic bullous keratopathy with subluxated posterior chamber IOL (PCIOL). Preoperative visual acuity ranged from hand movements close to face (LogMar 2.4) with accurate projection of rays to 1/60 (LogMar 2) due to existing corneal edema and aphakia. Postoperatively uncorrected visual acuity at 6 months improved up to 6/36 (LogMar 0.8) in all cases. There was gradual improvement in corneal clarity and compactness during the follow-up. A good donor tissue endothelial count and an adequate IOP control were vital prognostic factors for the successful outcome.
Conclusion This novel surgical merger reduces the complications of lenticule dislocation into vitreous and repeated surgeries and shows results akin to when performed in a staged manner.
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Affiliation(s)
- Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ankita Singh
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Rakesh Shetty
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | | | - Divya Kochhar
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Aanchal Singhal
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
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Kumar P, Kumar A, Dubakka S, Kaushik J, Agrawal M. Unilateral simultaneous optic nerve and choroidal infiltration - unusual presentation of metastatic disease in breast carcinoma. GMS Ophthalmol Cases 2021; 11:Doc14. [PMID: 34650902 PMCID: PMC8495234 DOI: 10.3205/oc000187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Breast carcinoma metastasis can involve any ocular structures, but involvement of the optic nerve is extremely rare. Choroidal metastasis is usually multifocal as well as bilateral and occurs late. We report an unusual initial presentation of metastasis from breast cancer; unilateral infiltrative optic neuropathy with concurrent choroid metastatic deposits in an adequately treated middle-aged female. Our present case, wherein for the first time in the literature, we illustrated unilateral infiltrative optic neuropathy and choroidal metastatic deposits secondary to breast carcinoma, will increase our knowledge about the various potential ocular presentations of this relatively common malignant disease.
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Affiliation(s)
- Poninder Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Ashok Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune, India,*To whom correspondence should be addressed: Ashok Kumar, Department of Ophthalmology, Armed Forces Medical College, 411040 Pune, India, E-mail:
| | - Srujana Dubakka
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Mohini Agrawal
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
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Kaushik J, Pannu A, Chaitanya YVK, Kumar A, Parihar JKS, Jain VK, Chaturvedi P, Manumala LK, Singh A, Kochhar D. Effect of complicated ocular surgery in stress-related parameters: A novel outlook into surgeon's health. Indian J Ophthalmol 2021; 69:2282-2286. [PMID: 34427199 PMCID: PMC8544032 DOI: 10.4103/ijo.ijo_3517_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: To assess the stress-related physiological parameters of ophthalmic surgeons during complicated cataract surgery and compare them with uncomplicated routine cataract surgery. Methods: In this cross-sectional observational study, 110 patients of various types of cataract were divided into two groups: Group 1 included 55 patients with simple cataract (Grade ≤3) with no ocular or systemic comorbidities, whereas Group 2 included 55 patients with complicated cataracts (Grade >3) and ocular/systemic comorbidities. All patients underwent phacoemulsification with intraocular lens implantation in the right eye only. The outcome measures were systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and saturation of peripheral oxygen (SpO2). Results: The average SBP, DBP, MAP, and HR were significantly higher in the surgeon operating Group 2 (complicated cataract) compared with Group 1 (uncomplicated cataract; P < 0.05). The average SBP of the surgeon while operating Group 1 patients preoperatively and postoperatively was 125.42 ± 2.49 mmHg and 122.45 ± 2.10 mmHg, respectively, whereas in Group 2, the average SBP of the surgeon taken preoperatively and postoperatively was 145.98 ± 3.80 mmHg and 137.44 ± 3.45 mmHg, respectively (P < 0.05). The surgeon’s SpO2 showed no significant difference between the two groups. Conclusion: There is a significant level of increase in stress-related parameters of operating surgeons while doing complicated cataract surgery.
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Affiliation(s)
- Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Anju Pannu
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Y V K Chaitanya
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ashok Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | | | - Vaibhav K Jain
- Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | | | - Lalita K Manumala
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ankita Singh
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Divya Kochhar
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
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Sharma VK, Sati A, Kaushik J, Kumar S, Agarwal M. Tuck In Femtosecond Laser Assisted Anterior Lamellar Keratoplasty (T-FALK) for the Management of Superficial Anterior Corneal Scars-A Modified Technique. Cornea 2021; 40:125-130. [PMID: 32947401 DOI: 10.1097/ico.0000000000002508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report a modified sutureless and glue-less technique, termed tuck in femtosecond laser assisted anterior lamellar keratoplasty (T-FALK), and to achieve a good graft-host junction apposition. METHODS This is a prospective interventional case series of 15 eyes of 15 patients who underwent T-FALK. Depth of the anterior corneal scar was assessed using anterior segment optical coherence tomography (ASOCT). The donor and recipient lenticules were prepared using femtosecond laser. After removing the recipient anterior scarred lenticule, the transparent donor lenticule was positioned on the recipient bed and margins tucked in under the recipient cornea. A bandage contact lens was applied for 3 weeks. Postoperatively, topical antibiotic and steroid combination eye drops were given, and the assessment of healing of the graft-host junction was done using ASOCT. RESULTS A total of 15 patients (8 men and 7 women) underwent T-FALK. Six patients had superficial corneal opacities after healed microbial keratitis, 5 patients had spheroidal corneal degeneration, 3 patients had Salzman nodular degeneration, and 1 patient had vortex keratopathy. No intraoperative or postoperative complications were noted during T-FALK. All patients had good graft-host junction apposition postoperatively, as demonstrated by ASOCT. CONCLUSIONS Sutureless and glue-less T-FALK can be the best way ahead for management of superficial anterior corneal scars with good visual outcome.
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Affiliation(s)
- Vijay K Sharma
- Department of Ophthalmology, Army Hospital Research and Referral, New Delhi, India
| | - Alok Sati
- Department of Ophthalmology, Army Hospital Research and Referral, New Delhi, India
| | - Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, India; and
| | - Santosh Kumar
- Department of Ophthalmology, Army Hospital Research and Referral, New Delhi, India
| | - Manisha Agarwal
- Department of Pathology, Army Hospital Research and Referral, New Delhi, India
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Chaitanya Y, Kumar A, Kaushik J, Singhal A, Dubbaka S. Severe Atypical Optic Neuritis in a Patient With Pemphigus Foliaceus on Immunosuppressive Therapy. Cureus 2021; 13:e16010. [PMID: 34336500 PMCID: PMC8319187 DOI: 10.7759/cureus.16010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 11/30/2022] Open
Abstract
Bilateral simultaneous acute optic neuritis is a rare occurrence in adults, which has been reported mostly in the setting of untreated systemic autoimmune disorders. Such clinical presentations are encompassed in the spectrum of ‘atypical’ optic neuritis with resultant poor visual outcome and mainly associated with neuromyelitis optica spectrum disorders. We report an unusual presentation, that is, severe atypical optic neuritis in a patient of pemphigus foliaceous on immunosuppressive therapy with significant visual recovery after treatment.
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Affiliation(s)
- Yvk Chaitanya
- Ophthalmology, Armed Forces Medical College, Pune, IND
| | - Ashok Kumar
- Ophthalmology, Armed Forces Medical College, Pune, IND
| | - Jaya Kaushik
- Ophthalmology, Armed Forces Medical College, Pune, IND
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24
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Jain VK, Agarwal R, Pal S, Kaushik J, Sharma K, Kanaujia V. Corneal biomechanical properties in patients with kidney transplant. Taiwan J Ophthalmol 2021; 11:141-145. [PMID: 34295619 PMCID: PMC8259527 DOI: 10.4103/tjo.tjo_24_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 04/23/2020] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The purpose of the study was to evaluate the corneal biomechanical properties in patients post kidney transplant and to compare them with healthy age-matched control. MATERIALS AND METHODS In this cross-sectional study, 68 patients with kidney transplant (study group) and 68 healthy individuals (control group) were analyzed with ocular response analyzer measurements. Only the right eye of each participant was assessed for corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc), and Goldmann-correlated intraocular pressure (IOPg). RESULTS The mean CH in the study group was 9.70 ± 1.62 mmHg which was significantly lower than the control group with the mean CH of 10.60 ± 1.49 mmHg (P = 0.001). The mean IOPcc was 18.17 ± 4.00 mmHg and 16.00 ± 3.94 mmHg in the study and control groups, respectively (P = 0.002). CRF and IOPg were not significantly different between groups. CONCLUSION CH and IOPccare altered in kidney transplant patients.
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Affiliation(s)
- Vaibhav Kumar Jain
- Department of Ophthalmology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Rachna Agarwal
- Department of Ophthalmology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Shabari Pal
- Department of Ophthalmology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Kumudini Sharma
- Department of Ophthalmology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vikas Kanaujia
- Department of Ophthalmology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Kumar A, Sahu A, Kaushik J, Arora A, Dubbaka S, Manumala LK. Unilateral submacular hemorrhage: Novel presentation of COVID-19 infection. J Med Virol 2021; 93:4122-4123. [PMID: 33792943 PMCID: PMC8251371 DOI: 10.1002/jmv.26991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Ashok Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Akanksha Sahu
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Amit Arora
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Srujana Dubbaka
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
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Ginu PM, Sati A, Murari T, Kaushik J, Mishra SK, Sharma VK. Ocular manifestations in renal allograft recipients: An Indian perspective. Indian J Ophthalmol 2021; 69:900-905. [PMID: 33727456 PMCID: PMC8012945 DOI: 10.4103/ijo.ijo_1120_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/25/2020] [Accepted: 09/30/2020] [Indexed: 11/16/2022] Open
Abstract
Purpose The aim of this study was to report the ocular findings in renal allograft recipients in India. Methods A cross-sectional, comprehensive ophthalmic evaluation was performed, at least three months postrenal transplant, in 152 renal allograft recipients for the ocular findings. In addition, ocular findings were assessed for an association with the clinical variables like major etiologies of end-stage renal disease, pre-transplant dialysis duration, post-transplant duration, and dosage of immunosuppressive drugs. Results 72.36% of the recipients (mean age, 38.16 ± 10.04 years) had at least one ocular finding at 3 ± 2.6 years (range, 0.3-14 years), postrenal transplant. Hypertensive retinopathy was the commonest ocular finding followed by posterior subcapsular cataract (20.4%), nuclear sclerosis (19.7%), diabetic retinopathy (15.1%), dry eye (11.2%), allergic conjunctivitis (9.9%), pterygium (6.6%), open-angle glaucoma (3.3%), meibomitis (3.3%), pinguicula (2.6%), chalazion (1.3%), subconjunctival haemorrhage (1.7%), central serous chorioretinopathy (1.7%), healed ocular toxoplasmosis (1.7%), papilledema (1.7%), and dry ARMD (1.7%). In addition, a significant association existed between some of the ocular findings with major aetiologies of ESRD, post-transplant duration, and dosage of immunosuppressive drugs. However, no association existed between the ocular findings and pre-transplant dialysis duration. Conclusion Ocular findings are seen in 72.36% of the renal transplant recipients with hypertensive retinopathy being the commonest one. Hence, a mandatory regular ophthalmic screening of the recipients is recommended for an early detection and timely intervention to improve the quality of life.
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Affiliation(s)
- PM Ginu
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Alok Sati
- Department of Ophthalmology, Army Hospital (Research and Referral), New Delhi, India
| | - T Murari
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India
| | - Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Sanjay Kumar Mishra
- Department of Ophthalmology, Army Hospital (Research and Referral), New Delhi, India
| | - Vijay Kumar Sharma
- Department of Ophthalmology, Army Hospital (Research and Referral), New Delhi, India
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Affiliation(s)
- Ashok Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Poninder Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Srujana Dubbaka
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
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Kaushik J, Singh A, Kochhar D, Murari T, Shetty R, Parihar JKS. Receptors modulation on the ocular surface: A novel insight into the ocular infection and disease transmission of SARS-COV-2. J Med Virol 2021; 93:2614-2615. [PMID: 33559886 PMCID: PMC8013457 DOI: 10.1002/jmv.26858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/26/2021] [Accepted: 02/07/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ankita Singh
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Divya Kochhar
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Thomala Murari
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India
| | - Rakesh Shetty
- Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
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Kaushik J, Shetty R, Singh A, Kumar P. Delleman–Oorthuys syndrome: A case report of an atypical variant. J Clin Ophthalmol Res 2021. [DOI: 10.4103/jcor.jcor_3_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Jain V, Kesarwani D, Agarwal R, Kaushik J, Sharma K. Corneal biomechanics in connective tissue disorders. J Clin Ophthalmol Res 2021. [DOI: 10.4103/jcor.jcor_74_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kumar A, Kumar P, Singh A, D S, Kaushik J. Bilateral premacular sub-hyaloid hemorrhage-unmasking COVID-19 induced pancytopenia. J Med Virol 2020; 93:2576-2577. [PMID: 33368339 DOI: 10.1002/jmv.26752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/16/2020] [Accepted: 12/19/2020] [Indexed: 01/04/2023]
Affiliation(s)
- Ashok Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Poninder Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Ankita Singh
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Srujana D
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
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Vannadil H, Moulick P, Khan M, Shankar S, Kaushik J, Sati A. Hyperglycaemia as a risk factor for the development of retinopathy of prematurity: A cohort study. Med J Armed Forces India 2020; 76:95-102. [PMID: 32020976 PMCID: PMC6994749 DOI: 10.1016/j.mjafi.2019.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 04/28/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Retinopathy of prematurity (ROP) is a preventable cause of childhood blindness. Without treatment, over 45% of eyes can develop permanent visual loss. Hyperglycaemia has recently been described as a risk factor for the development of retinopathy of prematurity (ROP), a proliferative vascular disease of the retina that primarily affects premature infants. The characteristic neoproliferative growth of blood vessels in the retina is very well under stood with the clinical and experimental experiences with Diabetic retinopathy. The purpose of this study was to evaluate a possible relation between glucose levels in VLBW (Very Low Birth Weight) infants and development of ROP. METHOD All at risk infants of a Neonatal Intensive Care Unit (NICU) of a tertiary care centre in western India were included in the study. The blood sugar values of the neonates were recorded at multiple times during their first week of life. On completion of 31 weeks of gestational age or 04 weeks of birth age, the neonates were subjected to ROP screening as per standard protocols. RESULT A total of 103 neonates were included in the study and were subjected to ROP screening. A total of 32 neonates developed ROP at the end of the study. It was found with statistical significance that the neonates with higher average blood glucose values in the initial period of life had higher incidence of ROP at the time of screening with a Relative Risk of 2.506 (CI = 1.287, 4.882). CONCLUSION A high average blood glucose level in neonates during the first week of life is an indicator for developing ROP at a later date. These neonates should be kept under close follow up in order to facilitate timely detection and prompt intervention.
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Affiliation(s)
- Harikrishnan Vannadil
- Resident, Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - P.S. Moulick
- Consultant (Ophthalmology), Command Hospital (Eastern Command), Kolkata, India
| | - M.A. Khan
- Professor (Ophthalmology), Command Hospital (Air Force), Bengaluru 07, India
| | - Sandeep Shankar
- Associate Professor, Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - Jaya Kaushik
- Associate Professor, Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - Alok Sati
- Associate Professor, Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
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Noori S, Sati A, Moulick PS, Kaushik J, Shankar S, Bose R. Tear film abnormalities in pseudoexfoliation syndrome and normal healthy participants: A comparative analysis. Med J Armed Forces India 2019; 76:303-306. [PMID: 32773933 DOI: 10.1016/j.mjafi.2019.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 01/17/2019] [Indexed: 11/15/2022] Open
Abstract
Background Pseudoexfoliative material is being implicated in causing tear film abnormalities, and the aim of the present study was to prove it and to compare with the normal healthy participants. Methods A total of 398 eyes of 200 participants were studied, and two groups were formed. The first, pseudoexfoliation syndrome (PEXS) group, included 198 eyes of 100 patients, and the second, age-matched control group, included 200 eyes of 100 participants. Tear film abnormalities were compared in the two groups by tear meniscus height (TMH), Schirmer test I, Schirmer test II and tear film break-up time (TBUT). Results On comparing the two groups using independent t-test, a significant difference was found in Schirmer test I, Schirmer test II, and TBUT between the PEXS group (Schirmer test I: 23.98 ± 10.68 mm, Schirmer test II: 17.11 ± 8.78 mm, and TBUT: 9.778 ± 5.54 s) and the age-matched control group (Schirmer test I: 27.08 ± 9.58 mm, Schirmer test II: 19.98 ± 8.48 mm, and TBUT: 13.495 ± 5.65 s) (p = 0.003 [Schirmer test I]; p = 0.001 [Schirmer test II]; and p < 0.001 [TBUT]). However, an insignificant difference was found in terms of TMH (p = 0.195) between the two groups. Conclusion PEXS affects tear production and leads to unstable tear film.
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Affiliation(s)
- Shukrullah Noori
- Resident, Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - Alok Sati
- Associate Professor, Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - P S Moulick
- Consultant (Ophthalmology), Command Hospital (Eastern Command), Kolkata 700027, India
| | - Jaya Kaushik
- Associate Professor, Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - Sandeep Shankar
- Associate Professor, Department of Ophthalmology, Armed Forces Medical College, Pune 411040, India
| | - Rupali Bose
- Assistant Professor (Ophthalmology), Command Hospital (Southern Command), Pune 411040, India
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Abstract
Purpose: To report a case of lepromatous iridocyclitis that posed a diagnostic challenge. Case Report: A 50-yeasr-old male developed profound loss of vision in the right eye, while he was in the hospital with septicemia presenting with fever, dysuria, and abdominal swelling. He also developed erythema nodosum on the legs. Skin incisional biopsy section, upon dermatology consultation, showed a granulomatous nodule in the dermis. The anterior chamber aspirate demonstrated lepra bacilli, which confirmed the diagnosis of lepromatous leprosy with type II reaction. The patient was treated with multidrug therapy and oral and topical steroids. Conclusion: This case highlights that the lepromatous iridocyclitis, a serious vision-threatening disorder requires a high index of suspicion for prompt diagnosis in atypical cases particularly in endemic areas. Examination of the aqueous humor can also be helpful in diagnosis.
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Affiliation(s)
- Jaya Kaushik
- Department of Ophthalmology, Military Hospital Pathankot, Punjab, India.,Department of Ophthalmology, Command Hospital Chandimadir, Panchkula, Haryana, India
| | - Vaibhav Kumar Jain
- Department of Ophthalmology, Uttar Pradesh University of Medical Sciences (U.P.U.M.S.), Saifai, Etawah, India
| | | | - Sanjay Dhar
- Department of Ophthalmology, Army Hospital, Research and Referral, Delhi Cantt., India
| | - Savita Agarwal
- Department of Pathology, Uttar Pradesh University of Medical Sciences (U.P.U.M.S.), Saifai, Etawah, India
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Trehan H, Kaushik J, Jain VK, Parihar JKS, Avasthi A. Endogenous Nocardial Endophthalmitis in an Immunosuppressed Patient: A Serious Warning of an Underlying Life Threatening and Blinding Disorder. J Ophthalmic Vis Res 2017; 12:113-116. [PMID: 28299015 PMCID: PMC5340051 DOI: 10.4103/2008-322x.200172] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: To report a case of bilateral endogenous nocardial endophthalmitis with central nervous system involvement in an immunocompromised individual with an extremely poor outcome. Case Report: A 35-year-old man with a history of long-term, prescribed oral steroid use for membranoproliferative glomerulonephritis presented with profound bilateral vision loss. Patient's diagnosis of bilateral endogenous nocardial endophthalmitis was delayed. Nocardia was finally isolated from a brain biopsy after a repeat magnetic resonance imaging revealed a brain abscess. With anti-nocardia therapy, patient improved systemically, but the visual outcome was poor, with no light perception in both eyes. Conclusion: Ocular nocardiosis is a serious vision and life threatening disorder, particularly in patients on immunosuppressive therapy. A high index of suspicion is required for successful treatment.
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Affiliation(s)
- Hemant Trehan
- Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantonment, India
| | - Jaya Kaushik
- Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantonment, India; Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vaibhav Kumar Jain
- Department of Ophthalmology, Uttar Pradesh Rural Institute of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
| | | | - Abhijit Avasthi
- Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantonment, India
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Parihar JKS, Parihar AS, Jain VK, Kaushik J, Nath P. Allogenic cultivated limbal stem cell transplantation versus cadaveric keratolimbal allograft in ocular surface disorder: 1-year outcome. Int Ophthalmol 2016; 37:1323-1331. [PMID: 28025793 DOI: 10.1007/s10792-016-0415-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 12/11/2016] [Indexed: 01/08/2023]
Abstract
PURPOSE To compare the outcome of allogenic ex vivo cultivated limbal stem cell transplantation (LSCT) versus cadaveric keratolimbal allograft in patients with limbal stem cell deficiency (LSCD). METHODS In this prospective interventional study from Army Hospital Research and Referral in New Delhi, 50 eyes of 40 patients with ocular surface disorder having LSCD underwent either cultivated LSCT (group 1: 25 eyes of 20 patients) or keratolimbal allograft transplantation (group 2: 25 eyes of 20 patients). The outcome measures were gain of two or more lines of best-corrected visual acuity (BCVA), absence of conjunctival vascularization over cornea, corneal neovascularization regression, regression of visually significant corneal opacity (iris details poorly visible), Schirmer's 1 ≥10 s, tear break-up time (TBUT) ≥10 s, and absence of fluorescein staining. RESULTS At 1 year of follow-up, both groups experienced significant improvement in all outcome measures, but there was no significant difference between both groups in improvement of two or more lines of BCVA (P = 0.841), absence of conjunctival vascularization over cornea (P = 0.812), corneal neovascularization (P = 0.074), visually significant corneal opacity (P = 0.075), Schirmer's 1 ≥10 s (P = 0.814), TBUT ≥10 s (P = 0.382), or absence of fluorescein stain (P = 1.00). CONCLUSION Both allogenic ex vivo cultivated LSCT and cadaveric keratolimbal allograft transplantation are comparable in terms of visual gain and ocular surface restoration.
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Affiliation(s)
| | | | - Vaibhav Kumar Jain
- Department of Ophthalmology, Uttar Pradesh Rural Institute of Medical Sciences & Research (U.P.R.I.M.S. & R.), Saifai, Etawah, India
| | - Jaya Kaushik
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (P.G.I.M.E.R.), Chandigarh, India
| | - Pramod Nath
- Department of Histopathology, Fortis Hospital Vasant Kunj, New Delhi, India
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Trehan HS, Kaushik J, Rangi A, Parihar AS, Vashisht P, Parihar JKS. Anterior segment changes on ultrasound biomicroscopy after intravitreal anti vascular endothelial growth factor injection. Med J Armed Forces India 2016; 73:58-64. [PMID: 28123247 DOI: 10.1016/j.mjafi.2016.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Intravitreal injections are standard of care today and have the potential to change the anatomy of the anterior segment of the eye. This research was undertaken to evaluate the changes in anterior segment anatomy after intravitreal anti vascular endothelial growth factor (anti VEGF) injections. METHODS We conducted a prospective interventional case series at a quaternary care center where patients undergoing intravitreal injection had pre and post injection ultrasound biomicroscopy (UBM) and intraocular pressure (IOP) measurement after intravitreal anti VEGF injection of 0.05 ml volume. RESULTS 75 eyes of 75 patients as per inclusion criteria were studied. A transient rise in IOP post intravitreal injection was found immediately after the injection. The mean rise from baseline was 17 mmHg immediately after injection and IOP returned to normal within 30 min in all cases. Angle measurement done as per established techniques revealed no significant changes in the angles and anterior chamber. CONCLUSION Intravitreal anti VEGF injections had no readily apparent short term concerns. IOP rise was transient and no case was found to have IOP high enough to cause concern for interruption of the optic nerve perfusion or statistically significant narrowing of the anterior chamber angle.
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Affiliation(s)
- H S Trehan
- Senior Advisor (Ophthalmology and Vitreoretinal Surgery), INHS Asvini, Colaba, Mumbai, India
| | - Jaya Kaushik
- Classified Specialist (Ophthalmology) Command Hospital (Western Command), Chandimandir, India
| | | | - A S Parihar
- Classified Specialist (Ophthalmology), INHS Dhanvantari, Port Blair, Andaman and Nicobar Islands, India
| | - P Vashisht
- Graded Specialist (Ophthalmology), INHS Asvini, Colaba, Mumbai, India
| | - J K S Parihar
- Addl DGAFMS (MR, H & Trg), O/o DGAFMS, Ministry of Defence, 'M' Bock, New Delhi 110001, India
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Parihar JKS, Kaushik J, Jain VK, Naredi N, Raina S. The effect of assisted reproductive technology on ocular assessments. Clin Exp Optom 2016; 99:575-579. [PMID: 27306565 DOI: 10.1111/cxo.12389] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 02/03/2016] [Accepted: 02/10/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The aim was to study the various ocular assessments in women undergoing assisted reproductive techniques (ART). METHODS A total of 117 women with infertility were enrolled for study and the ART protocol was followed. The outcome measures were intraocular pressure (IOP), central corneal thickness, corneal endothelial cell counts, Schirmer I test done at baseline (V0), post-oral contraceptive (V1), post-GnRH agonist induction phase (V2), post-conception (V3), third trimester of pregnancy (V4) and three months post-partum (V5). Schirmer I test (without topical anaesthesia) less than 10 mm in at least one eye was considered a criterion for dry eye. RESULTS Out of 117 women enrolled for in vitro fertilisation (IVF), only 48 patients conceived. Sixteen women had abortions and remaining 32 women, who had childbirth were followed until three months post-partum. Baseline mean IOP showed a slight decrement and corneal pachymetry and corneal endothelial cell counts showed slight increment from phases V1 to V4 of ART but statistically they were not significant (p > 0.05). At three months post-partum (V5) mean IOP, corneal pachymetry, corneal endothelial cell counts become closer to baseline in both eyes. The number of patients with at least one eye with dryness (Schirmer I less than 10 mm) significantly increased at the third trimester (p = 0.02) and three months post-partum (p = 0.035), whereas in the rest of the phases, it was comparable to baseline (p > 0.05). CONCLUSION The ocular physiological changes (IOP, corneal pachymetry and corneal endothelial cell counts) seen in various phases of ART were non-specific. The ART appears to reduce tear secretions as measured by Schirmer I; however, further research would be required to determine the impact of ART on the tear film and whether ART is associated with symptoms and signs of dry eye.
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Affiliation(s)
| | - Jaya Kaushik
- Department of Ophthalmology, Command Hospital (WC), Chandimandir Cantonment, India
| | - Vaibhav Kumar Jain
- Department of Ophthalmology, Uttar Pradesh Rural Institute of Medical Sciences and Research, Etawah, India
| | - Nikita Naredi
- Department of Obstetrics & Gynecology & Assisted Reproductive Treatment Centre, Command Hospital (SC), Pune, India
| | - Sapna Raina
- Department of Ophthalmology, Air Force Central Medical Establishment, New Delhi, India
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Parihar JKS, Jain VK, Kaushik J, Mishra A. Pars Plana-Modified versus Conventional Ahmed Glaucoma Valve in Patients Undergoing Penetrating Keratoplasty: A Prospective Comparative Randomized Study. Curr Eye Res 2016; 42:436-442. [PMID: 27348314 DOI: 10.1080/02713683.2016.1185130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare the outcome of pars-plana-modified Ahmed glaucoma valve (AGV) versus limbal-based conventional AGV into the anterior chamber, in patients undergoing penetrating keratoplasty (PK) for glaucoma with coexisting corneal diseases. METHOD In this prospective randomized clinical trial, 58 eyes of 58 patients with glaucoma and coexisting corneal disease were divided into two groups. Group 1 (29 eyes of 29 patients) included patients undergoing limbal-based conventional AGV into the anterior chamber (AC) along-with PK and group 2 (29 eyes of 29 patients) included those undergoing pars-plana-modified AGV along-with PK. Outcome measures included corneal graft clarity, intraocular pressure (IOP), number of antiglaucoma medications, and postoperative complications. Patients were followed up for a minimum period of 2 years. RESULTS Out of 58 eyes (58 patients), 50 eyes (50 patients: 25 eyes of 25 patients each in group 1 and group 2) completed the study and were analyzed. Complete success rate for AGV (group 1: 76%; group 2: 72%; p = 0.842) and corneal graft clarity (group 1: 68%; group 2: 76%; p = 0.081) were comparable between the two groups at 2 years. Graft failure was more in conventional AGV (32%) as compared to pars plana-modified AGV (24%) but not statistically significant (p = 0.078) at 2 years. CONCLUSION Though both procedures were comparable in various outcome measures, pars-plana-modified AGV is a viable option for patients undergoing PK, as it provides a relatively better corneal graft survival rate and lesser complications that were associated with conventional AGV.
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Affiliation(s)
| | - Vaibhav Kumar Jain
- b Department of Ophthalmology , Uttar Pradesh Rural Institute of Medical Sciences & Research , Saifai , Etawah , India
| | - Jaya Kaushik
- c Department of Ophthalmology , Advance Eye Centre, Post Graduate Institute of Medical Education and Research , Chandigarh , India
| | - Avinash Mishra
- d Department of Ophthalmology , Command Hospital (EC) , Kolkata , West Bengal , India
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Kaushik J, Parihar JKS, Jain VK, Gupta S, Nath P, Durgapal P, Ram J. Efficacy of Bevacizumab Compared to Mitomycin C Modulated Trabeculectomy in Primary Open Angle Glaucoma: A One-Year Prospective Randomized Controlled Study. Curr Eye Res 2016; 42:217-224. [DOI: 10.3109/02713683.2016.1164188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jaya Kaushik
- Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantt., India
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Vaibhav Kumar Jain
- Department of Ophthalmology, Uttar Pradesh Rural Institute of Medical Sciences & Research, Saifai, Etawah, India
| | - Sandeep Gupta
- Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantt., India
| | - Pramod Nath
- Department of Histopathology, Fortis Hospital, Vasant Kunj, New Delhi, India
| | - Prashant Durgapal
- Department of Histopathology, Uttar Pradesh Rural Institute of Medical Sciences & Research, Saifai, Etawah, India
| | - Jagat Ram
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Parihar JKS, Jain VK, Chaturvedi P, Kaushik J, Jain G, Parihar AKS. Computer and visual display terminals (VDT) vision syndrome (CVDTS). Med J Armed Forces India 2016; 72:270-6. [PMID: 27546968 DOI: 10.1016/j.mjafi.2016.03.016] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 03/27/2016] [Indexed: 10/21/2022] Open
Abstract
Computer and visual display terminals have become an essential part of modern lifestyle. The use of these devices has made our life simple in household work as well as in offices. However the prolonged use of these devices is not without any complication. Computer and visual display terminals syndrome is a constellation of symptoms ocular as well as extraocular associated with prolonged use of visual display terminals. This syndrome is gaining importance in this modern era because of the widespread use of technologies in day-to-day life. It is associated with asthenopic symptoms, visual blurring, dry eyes, musculoskeletal symptoms such as neck pain, back pain, shoulder pain, carpal tunnel syndrome, psychosocial factors, venous thromboembolism, shoulder tendonitis, and elbow epicondylitis. Proper identification of symptoms and causative factors are necessary for the accurate diagnosis and management. This article focuses on the various aspects of the computer vision display terminals syndrome described in the previous literature. Further research is needed for the better understanding of the complex pathophysiology and management.
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Affiliation(s)
- J K S Parihar
- Addl DGAFMS (MR, H & Trg), O/o DGAFMS, Ministry of Defence "M" Block, New Delhi 110001, India
| | - Vaibhav Kumar Jain
- Assistant Professor, Dept of Ophthalmology, Uttar Pradesh Rural Institute of Medical Sciences & Research, Saifai, Etawah, UP, India
| | - Piyush Chaturvedi
- Classified Specialist (Ophthalmology), On study leave at Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jaya Kaushik
- Classified Specialist (Ophthalmology) & Anterior Segment Surgeon, Command Hospital (Western Command), Chandimandir, India
| | - Gunjan Jain
- Senior Resident, Dept of Paediatric, Uttar Pradesh Rural Institute of Medical Sciences & Research, Saifai, Etawah, UP, India
| | - Ashwini K S Parihar
- Chhattisgarh Institute of Medical Sciences (CIMS), Bilaspur, Chhattisgarh, India
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Kaushik J, Jain AK, Jain VK, Chakma P. Phacoemulsification in a rare case of keratoconus with Fuch's endothelial corneal dystrophy. Int J Ophthalmol 2015; 8:1253-4. [PMID: 26682183 DOI: 10.3980/j.issn.2222-3959.2015.06.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 12/19/2014] [Indexed: 11/02/2022] Open
Affiliation(s)
- Jaya Kaushik
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Arun Kumar Jain
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Vaibhav Kumar Jain
- Department of Ophthalmology, Uttar Pradesh Rural Institute of Medical Sciences & Research, Saifai, Etawah 20130, India
| | - Partha Chakma
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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