Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India.

Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a spectrum of rare, severe immunological blistering skin reactions which are triggered by medication intake or infections. The acute phase is characterized by necrolysis of the skin and desquamation of mucosa, primarily oral and ocular, with significant mortality rates. The chronic phase is characterized by multi-organ sequelae with increased rates of morbidity and reduced quality of life for patients who have survived the acute phase.

Systemic Immunosuppression in Cornea and Ocular Surface Disorders: A Ready Reckoner for Ophthalmologists.

Purpose: Many diseases of the cornea and ocular surface are manifestations of an underlying autoimmune process and require systemic immunosuppression for their management. These cases often present to a general ophthalmologist before being referred to an ocular immunologist or rheumatologist. However, the patients do need to be followed by the ophthalmologist to assess disease progression or for management of ocular co-morbidities and for taking care of ocular complications of the disease.

Morphological variants of meibomian glands: correlation of meibography features with histopathology findings.

Purpose: This study describes the histopathological features of different morphological variants of human meibomian glands (MGs) seen on infrared imaging.

Methods: Tarsal plates dissected from seven cadaveric upper eyelids were imaged using infrared meibography, and then studied histopathologically using H&E, peroxisome proliferator-activated receptor gamma (PPARγ, meibocyte differentiation marker) and Ki-67 (cellular proliferation marker) antibody staining. The different morphological characteristics (varying size and shape) of MGs on meibography were correlated with histopathology findings using image analysis software.

Unusual Presentation of Keratitis as Peripheral Ulcerative Keratitis: Clinical Dilemma.

Purpose: To describe the clinical picture and outcome of a case of Pythium keratitis, presenting as peripheral ulcerative keratitis (PUK).

Case Summary: A 54- year- old male presented to the clinic with a PUK in the right eye. Systemic investigations were performed to rule out associated collagen vascular disorders.

Clinical clues to the early diagnosis and management of ocular surface neoplasia following keratoplasty in xeroderma pigmentosa.

The purpose of this report is to highlight the early clinical signs and management of ocular surface neoplasia following penetrating keratoplasty in xeroderma pigmentosa. A 14-year-old girl reported increased conjunctival hyperemia, tearing, photophobia in the right eye at 6 months after penetrating keratoplasty that worsened rapidly over the subsequent 2 weeks. Slit lamp examination showed increased vascularity, epithelial haze and raised whitish lesions at the graft-host junction.

Predictive Factors for Resolution of Dematiaceous Fungal Keratitis.

Purpose: To ascertain the clinicomicrobiological correlation and evaluate the prognostic factors associated with medical resolution in cases of Curvularia, Alternaria, and Scedosporium keratitis.

Methods: A retrospective review of clinical and microbiological records of culture-proven cases of Curvularia, Alternaria, and Scedosporium keratitis from 2017 to 2019 was performed. Multivariate logistic regression analyses were performed to assess the predictive factors for medical resolution.

Outcomes of Descemet-Stripping Endothelial Keratoplasty in 52 Eyes With Iridocorneal Endothelial Syndrome.

Purpose: To evaluate the long-term outcomes of Descemet-stripping endothelial keratoplasty (DSEK) in 52 eyes with iridocorneal endothelial (ICE) syndrome.

Methods: Retrospective study of 52 eyes of 52 patients who were diagnosed with ICE syndrome and underwent DSEK between January 2010 and December 2019 with a follow-up of at least 6 months.

Results: The mean age was 48.

Anterior segment imaging using a simple universal smartphone attachment for patients.

To assess the utility of a universal smartphone attachment to capture images of the anterior segment of the eye, we conducted a retrospective analysis of 344 images captured using a smartphone by the patients to identify factors affecting image quality, such as lack of perspective, lack of focus, improper illumination, and resolution. Based on this analysis, a universal smartphone attachment named GrabiLite and a protocol for anterior segment imaging were designed and validated in the first prospective arm of 60 patients. These images were then compared with the same eyes imaged on the gold standard slit-lamp photography.

Feasibility and Outcomes of Corneal Transplantation Performed at Rural Centers: An Extension of the Pyramidal Model of Enhanced Eye Care at Rural Outreach.

Purpose: The aim of this study was to report on the feasibility of setting up a system of corneal transplants at rural outreach centers and report the outcomes of the first 111 cases.

Methods: Retrospective analysis of the outcomes of corneal transplantation performed on patients with optical indications between March 2016 and September 2019 at 4 secondary (rural) centers. The centers are a part of a network in the pyramidal model developed by L V Prasad Eye Institute.

Descemet Stripping Automated Endothelial Keratoplasty in Pediatric Age Group: A Decade of Our Experience.

Purpose: This study was to report the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) in managing corneal endothelial disorders in children less than 14 years of age.

Methods: Medical records of 180 DSAEK performed, between 2008 and 2020, on 167 eyes of 111 children who had a visually significant endothelial dysfunction were retrospectively reviewed for the primary etiology of corneal decompensation, time of the onset and duration of cloudiness, preoperative visual acuity, the technique of endothelial keratoplasty, surgical modifications, and reintervention.

Results: Median age at surgical intervention was 7.

Ocular Surface Squamous Neoplasia With Coexistent Microbial Keratitis: Incidence, Risk Factors, Clinical Features, Microbiological Profile, and Treatment Outcome.

Purpose: The purpose of this study was to evaluate the incidence, clinical features, microbiology, risk factors, and treatment outcomes in cases of ocular surface squamous neoplasia (OSSN) with coexisting microbial keratitis (MK).

Methods: This was a retrospective case-control study from a cohort of 939 cases with OSSN.

Results: Twenty eyes (2%) with OSSN and MK were included in the study group and 100 age-matched eyes with only OSSN as controls.

Chronic Ocular Sequelae and Subsequent Surgical Interventions in Stevens-Johnson Syndrome After Amniotic Membrane Transplantation.

Purpose: The purpose of this study was to describe the chronic ocular sequelae and subsequent surgical interventions after amniotic membrane transplantation (AMT) in a patient with Stevens-Johnson syndrome (SJS).

Methods: A 30-year-old woman was diagnosed with SJS after taking phenytoin prescribed for generalized tonic-clonic seizures. Bedside AMT covering the eyelid margins, the conjunctiva, and the cornea was performed in both eyes during the acute phase during hospitalization.

Isolated keratinising corneal ocular surface squamous neoplasia with multifocal recurrence.

Corneal ocular surface squamous neoplasia usually begins at the limbus and presents as an avascular translucent sheet over the corneal surface. This case report describes a 67-year-old man with an unusual isolated, keratinous nodular corneal lesion. Slit-lamp examination showed an elevated, avascular, whitish plaque-like lesion at the central cornea surrounded by a normal corneal epithelium, with reduced visual acuity of 20/200 in the right eye.

Outcomes of Ahmed Glaucoma Valve Implantation in Eyes with Pediatric Keratoplasty.

Purpose: This study aimed to assess the efficacy and safety of Ahmed glaucoma valve (AGV) (New World Medical Inc.) implantation in eyes with pediatric keratoplasty and glaucoma.

Design: Retrospective, noncomparative, interventional case series.

Vogt Koyanagi Harada Disease In Paediatric Age Group: Clinical Characteristics, Remission, Recurrences and Complications in Asian Indian Population.

Purpose: To describe disease characteristics and outcomes of Vogt-Koyanagi-Harada (VKH) syndrome in paediatric patients.

Study Design: Retrospective chart analysis.

Methods: A Retrospective: Analysis of all patients ≤16 years with VKH syndrome was done.

High-Resolution Optical Coherence Tomography Angiography Characteristics of Limbal Stem Cell Deficiency.

This study aimed to identify the anterior segment high-resolution optical coherence tomography (HR-OCT) and HR-OCT angiography (HR-OCTA) features suggestive of limbal stem cell deficiency (LSCD) as confirmed by both impression cytology (IC) and in vivo confocal microscopy (IVCM). This was a single-centre prospective cross-sectional study including 24 eyes of 22 patients with clinical suspicion of LSCD based on peripheral superficial corneal vascularisation and scarring. On IC and IVCM, performed and interpreted by blinded observers, 12 eyes each were diagnosed with and without LSCD.

Effect of Antimicrobial Contact Lenses on Corneal Infiltrative Events: A Randomized Clinical Trial.

Purpose: To determine whether Mel4-coated antimicrobial contact lenses (MACLs) can reduce the incidence of corneal infiltrative events (CIEs) during extended wear.

Methods: A prospective, randomized, double-masked, single-center, contralateral, extended contact lens wear clinical trial was conducted with 176 subjects. Each participant was randomly assigned to wear a MACL in one eye and an uncoated control contact lens in the contralateral eye or an extended-wear biweekly disposable modality for 3 months.

Dye-based identification of the orientation of tissue for Descemet stripping automated endothelial keratoplasty: A laboratory-based study.

Purpose: To describe the features enabling the identification of the orientation of Descemet stripping automated endothelial keratoplasty (DSAEK) lenticule with the assistance of vital dyes.

Methods: This is a blinded experimental lab-based study, including 30 microkeratome prepared precut DSAEK lenticules. The lenticules were divided into control and study arms which included 10 unstained and 20 stained lenticules, respectively.

Histopathological Characteristics of Limbal Stem Cell Deficiency Secondary to Chronic Vernal Keratoconjunctivitis.

Purpose: To describe the histopathological characteristics of limbal stem cell deficiency (LSCD) due to chronic vernal keratoconjunctivitis (VKC).

Methods: This retrospective study included 14 eyes of 13 patients who underwent simple limbal epithelial transplantation for total LSCD from 2017 to 2018. The histological characteristics of the excised fibrovascular pannus were compared between 2 groups of 7 eyes, each with LSCD due to VKC and chemical burns (CB).

Herpes Simplex Virus Anterior Uveitis in a Child Presenting as a Hypopyon in a White Eye.

Purpose: To report a rare ocular presentation of unilateral anterior uveitis with hypopyon in a 5-year-old child, suspected as masquerade.

Methods: Retrospective report.

Results: A 5-year-old boy presented with hypopyon-uveitis.