The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had health implications of unprecedented magnitude. The infection can range from asymptomatic, mild to life ...threatening respiratory distress. It can affect almost every organ of the body. Ophthalmologists world over are reporting various manifestations of the infection in the eye. This review was undertaken to help ophthalmologists recognize the possible manifestations and the stage of the viral disease when they commonly appear. Literature search was performed for the publications on ophthalmic manifestations of coronavirus disease-19 (COVID-19) between January 1, 2020 and January 31, 2021. 46 case reports, 8 case series, 11 cross sectional/cohort observational studies, 5 prospective interventional studies, 3 animal models/autopsy studies and 6 reviews/meta-analysis were included. Conjunctivitis is the most common manifestation and can develop at any stage of the disease. Direct effect due to virus, immune mediated tissue damage, activation of the coagulation cascade and prothrombotic state induced by the viral infection, the associated comorbidities and drugs used in the management are responsible for the findings in the eye. The viral ribonucleic acid (RNA) has been isolated from ocular tissues but the role of eye as a route for infection is yet to be substantiated. Ophthalmic manifestations may be the presenting feature of COVID-19 infection or they may develop several weeks after recovery. Ophthalmologists should be aware of the possible associations of ocular diseases with SARS-CoV-2 in order to ask relevant history, look for specific signs, advise appropriate tests and thereby mitigate the spread of infection as well as diagnose and initiate early treatment for life and vision threatening complications.
The COVID-19 pandemic has brought with it the huge burden of mortality and morbidity across the world and the added effects of the mandatory lockdown measures to try and control the spread. A number ...of aspects of healthcare including eye donation and eye collection require adequate safety precautions in place to keep both the involved healthcare workers and patients safe. This paper highlights the consensus-based guidelines by an expert panel on how to restart eye banking and eye collection services and carry out emergency corneal surgeries during this COVID-19 time. These guidelines will be applicable to all eye banks across the country and should help ophthalmologists and eye banking staff to restart eye banking while safeguarding themselves and their patients.
To assess the long-term safety and stability of visual outcomes following the modified technique of collagen crosslinking (CXL) using refractive lenticule in eyes with thin corneas (<400 µm) and ...progressive keratoconus.
A tertiary eye care hospital in India.
Prospective, interventional case series.
Eyes with progressive keratoconus and thin corneas (<400 µm) underwent CXL with intraoperative stromal augmentation using a refractive lenticule obtained from small-incision lenticule extraction (SMILE). Preoperative and postoperative evaluation (3 months, and then yearly thereafter) included corneal tomography (Oculus Pentacam), uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively), manifest refraction, and endothelial cell count (specular microscopy), and adverse events, if any, were noted. The patients were followed up for a period of 5 years.
Seven eyes were included in the analysis. Mean corneal flattening of -4.29 D was noted from preoperative maximum keratometry (P = 0.018). An improvement in UDVA and CDVA of 0.38 logarithm of minimum angle of resolution (logMAR) and 0.36 logMAR, respectively, was noted at 5 years postoperative visit. Four eyes demonstrated a gain of two lines in CDVA. Mean spherical equivalent improved from -6.85 D preoperatively to -6.05 D at 5 years postoperatively. Clear demarcation line was noted between 230 to 270 µm on anterior segment optical coherence topography. No significant endothelial cell loss was noted postoperatively.
Long-term outcomes demonstrated safety and disease stability following lenticule-assisted CXL.
The COVID-19 Pandemic has prompted substantial changes in the way ophthalmology is practiced globally. General guidelines on safe ophthalmic practice have been issued by various bodies across the ...globe including the All India Ophthalmological Society. While these are suitable to ophthalmology overall, they are not entirely suitable to a subspecialty practice, particularly pediatric ophthalmology, strabismus and neuro-ophthalmology, which entails dealing with children, surgery under general anesthesia and managing possible life threatening situations. A group of sub-specialists and anesthetists met virtually and arrived at a consensus with regard to practice and general anesthesia protocols pertaining to these subspecialties of ophthalmology. The recommendations made by the expert group are specific yet can be universally followed to ensure the best and safest outcome for the practitioner and patient alike. The recommendations pertain to listing conditions which need emergency or urgent care in the fields of pediatric ophthalmology and neuro-ophthalmology, precautions and technique of pediatric and neuro-ophthalmic eye examination and a protocol for delivering a safe general anesthesia for a pediatriceye surgery.
1 Since then, cataract surgery has evolved through leaps and bounds with extracapsular cataract extraction, small incision manual cataract surgery (SICS), phacoemulsification, and femtosecond laser ...cataract surgery as a few of the landmark milestones. Advances in IOL optics include the advent of foldable aspheric profile lenses and toric and multifocal lens implants. The use of dyes to stain the anterior lens capsule and vitreous in the event of a capsular dehiscence enable better visualization and subsequent management.
Tele-ophthalmology: Need of the hour Sharma, Mohita; Jain, Neha; Ranganathan, Sridhar ...
Indian journal of ophthalmology,
07/2020, Letnik:
68, Številka:
7
Journal Article
Recenzirano
Odprti dostop
Telemedicine and tele-ophthalmology have been in existence since many years, but have recently gained more importance in the present scenario of pandemic COVID-19. The attitude and perception of the ...doctors and patients has been changing gradually. Telemedicine has many advantages including providing care in inaccesible areas.In the present scenario, tele-ophthalmology gives an oppurtunity to patient for seeking consultation while also protecting against the contagion. There are many barriers faced by the patients and doctors that have restricted use of this technology in the past. However, with a systematic approach to designing the best suited technology, these barriers can be overcome and user friendly platforms can be created. Furthermore, the demand and use of teleconsulation had increased presently in this area of pandemic. Recent survey conducted by the All India Ophthalmological Society also reveals that many ophthalmologists who have not used tele-ophthalmology in the past are more keen to use it presently. In this article, we have reviewed telemedicine and tele-ophthalmology literature on Google and PubMed to get a holistic idea towards teleconsultation, its advantages, increased importance and prefrence during COVID-19 pandemic and various barriers faced so that the known challenges can be understood, which can pave way for better understanding and future incorporation into practice.
We describe a case of unilateral corneal ectasia in a 26-year-old man following small-incision lenticule extraction. The preoperative corneal topography was normal, with a minimum corneal thickness ...of 511 μm and 513 μm in the right eye and left eye, respectively. Lenticules of 85 μm and 82 μm were fashioned to offer a refractive correction of -3.75 -1.50 × 180 and -3.50 -1.50 × 165 in the right eye and left eye, respectively. Twelve months after small-incision lenticule extraction, the patient presented with early signs of ectasia in the left eye on corneal topography, which had worsened at the 18-month examination. Intrastromal corneal ring segment implantation with corneal collagen crosslinking was performed to arrest further progression and to improve uncorrected distance visual acuity. On the last examination, the corrected distance visual acuity was 20/20(-2).
Dr. Mahipal S. Sachdev receives travel grants from Carl Zeiss Meditec AG. No author has a financial or proprietary interest in any material or method mentioned.
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