Objective The objective of this study was to assess the efficacy of low-dose atropine 0.01% in controlling myopia progression among Indian children over a 2-year period. Methods This retrospective study, conducted across 20 centres in India, monitored the progression of myopia over 2 years after initiating treatment with 0.01% atropine eye drops. This included children between 6 and 14 years with baseline myopia ranging from −0.5 D to −6 D, astigmatism≤−1.5 D, anisometropia ≤ −1 D and documented myopia progression of ≥0.5 D in the year prior to starting atropine. Subjects with any other ocular pathologies were excluded. Results A total of 732 children were included in the data analysis. The mean age of the subjects was 9.3±2.7 years. The mean myopia progression at baseline (1 year before starting atropine) was −0.75±0.31 D. The rate of myopia progression was higher in younger subjects and those with higher baseline myopic error. After initiating atropine, myopia progression significantly decreased to −0.27±0.14 D at the end of the first year and −0.24±0.15 D at the end of the second year (p < 0.001). Younger children (p<0.001) and higher baseline myopia (p<0.001) was associated with greater myopia progression and poor treatment response (p<0.001 for both). Conclusion Low-dose atropine (0.01%) effectively reduces myopia progression over 2 years in Indian children.
Purpose: To analyze the genetic referral practices of pediatric ophthalmologists in an urban setting. Methods: (1) The first limb of the study: cross-sectional, observational study among children visiting the outpatient department of pediatric ophthalmology across five centers in Mumbai. All pediatric patients were screened separately by pediatric ophthalmologists and a clinical geneticist for their ophthalmic and systemic complaints. Children were marked for referral to genetics (RTG) by both the specialists based on identification of distinctive features (red flag) and were requested to meet a local geneticist. (2a) Twenty-three months later, patients who had been marked for RTG were contacted telephonically to follow-up if they had met the geneticist. (2b) Additionally, the last 20 proformas from each center were checked retrospectively to note the RTG marked by the ophthalmologist alone. Results: (1) In the first aspect of the study, 126 patients (male: female = 1.2:1) were included. Forty-nine (38.3%) patients were referred for genetic evaluation, of which three (6.1%), 31 (63.26%), and 15 (30.6%) cases were referred by the ophthalmologist alone, geneticist alone, and by both the specialists, respectively. Glaucoma (100%), nystagmus (86%), and leukocoria (83%) were the most prominent ocular diagnoses in cases referred for genetic evaluation. Facial dysmorphism (55.1%) and neurodevelopmental delays (51%) were among the most common systemic red flags found in patients referred to genetics. (2a) Twenty-three months later, on contacting the 49 patients marked for RTG, only one family had met the geneticist. (2b) Retrospective evaluation of 100 proformas: only three patients were marked for RTG by ophthalmologist alone. Conclusion: This study found that the genetic referrals by pediatric ophthalmologist were far lesser than those by geneticist. The study highlights an area of knowledge gap among pediatric ophthalmologists, prompting a need for heightened awareness in this area.
A rare case of symptomatic Rathke cleft cyst resulting in severe visual compromise in a young 45 yr/f who presented with gradual progressive painless diminution of vision in both eyes. Patient noticed diminution of vision in the Left eye an year ago and later on in the Right eye for which she consulted ophthalmologists. She was diagnosed as optic neuritis and underwent treatment for the same, but vision didn’t improve. At presentation,vision in Both eyes was same, counting fingers at 2 meters. Pupillary reactions were normal, however there was bilateral disc pallor and rest fundus was normal. On systemic evaluation patient gave history of irregular menstrual periods since 3-4 months. on further investigation her S. Prolactin levels were markedly raised(59.99ng/ml). Radiology showed well defined hyperintense suprasellar lesion. Patient was operated for right frontotemporal craniotomy with decompression of RCCs by a neurosurgeon. 2 months post surgery visual acuity in RE 4/60 and LE is counting finger close to face.
Ocular chemical injuries accounts for 11.5% to 22.1% of ocular injuries. Ocular chemical burns are an ophthalmic emergency and requires immediate treatment. We report a series of three cases of chemical injury secondary to accidental exposure to red balm used as local application for headache. In our cases menthol, cajuput oil and capsaicin might have contributed to chemical injury and nerve damage. Nerve damage might have lead to delayed epithelial healing. All three patients improved completely within 1 to 3 week.
