Sankara Eye Hospital is a not for profit charitable trust which aims at providing affordable eye care and eliminating curable eye blindness in India. Having its headquarters in Coimbatore, Tamil Nadu, Sankara is among the largest community eye care providers in India with ten super specialty eye care hospitals across the country performing over 150,000 free eye surgeries annually.The hospital follows an 80:20 business model, in which 80 percent of the patients from rural parts of the country are treated for free, and the remaining 20 percent are the rich and the middle income sections of the society, who pay for their treatment, thereby cross-subsidizing the free surgeries and making the Hospital self-sustaining.In 2013, Sankara conducted its one millionth free eye surgery.
To evaluate the surgical outcomes of a combined modified Nishida's procedure with medial rectus (MR) recession augmented with lateral rectus (LR) plication in patients with long-standing complete sixth nerve palsy presenting with large-angle esotropia (ET). This retrospective interventional case series included three patients with chronic traumatic complete sixth nerve palsy and large-angle ET (70 to 75 prism diopters [PD]). Postoperatively, two patients achieved orthophoria at distance and near and one patient had a small residual ET of 5 PD at 6 months. The combination of modified Nishida's procedure with MR recession and LR plication appears to be an effective single-stage surgical approach for large-angle esotropia (approximately 70 PD) associated with complete sixth nerve palsy. The technique provides substantial alignment correction, improved abduction, resolution of diplopia, and a reduced risk of anterior segment ischemia compared to full-tendon vertical rectus transposition.
To compare the anatomical and functional outcomes of patients with small- to medium-sized idiopathic macular holes (MHs) treated with air or sulfur hexafluoride (SF6) gas tamponade in prone and nonprone positions. This was a multicentric randomized study of patients who were diagnosed with idiopathic small- to medium-sized (minimum linear diameter 250–400 μm) full-thickness macular holes and who underwent pars plana vitrectomy with inverted internal limiting membrane peeling. Patients were randomized into three groups: Group 1, air tamponade with prone positioning; Group 2, SF6 with prone positioning; and Group 3, SF6 without prone positioning. The primary outcomes assessed were the anatomical closure of MH and the type of MH closure. The secondary outcomes assessed were changes in best-corrected visual acuity (BCVA), postoperative changes on OCT and intraocular pressure (IOP). Eighty patients were enrolled in the study. The overall degree of anatomical closure was 92.5
Cataracts represent the leading cause of blindness worldwide, particularly in older adults, and constitute a significant public health challenge. Although cataract surgery is generally associated with a high safety profile, both patients and healthcare providers often face significant challenges due to age-related physiological changes and the high prevalence of comorbidities, which are directly linked to cataractogenesis and other systemic diseases that can complicate both the surgical procedure and postoperative recovery. This narrative review aimed to assess the epidemiological characteristics of age-related physiological and pathological comorbidities in older adults with cataracts, evaluating their impact on preoperative assessment, surgical outcomes, and public health planning. Articles were identified through non-systematic searches of PubMed, EMBASE, and Scopus using a combination of medical subject headings (MeSH) terms and free-text keywords. Among the multiple non-ocular comorbidities, carotid artery disease (CAD) and hypertension (HTN) are among the cardiovascular diseases (CVDs) with the highest correlations with cataract. Diabetes, dyslipidemia, and metabolic syndrome are also highly prevalent and significantly influence surgical outcomes, as poor glycemic control increases intraoperative risks and postoperative complications. Additionally, neurological conditions such as stroke, Parkinson’s disease, and epilepsy often complicate anesthesia administration, contribute to postoperative delirium, and affect adherence to treatment protocols. Given these complexities, a multidisciplinary approach and targeted preoperative screening may offer personalized care to improve safety and outcomes. Despite advances in clinical care, disparities in access to cataract surgery, especially in underserved populations, continue to exist. Thus, a coordinated public health strategy that promotes early detection, equitable access, and the integration of innovations such as teleophthalmology and artificial intelligence is essential to optimize care for older adults with cataracts worldwide.
Purtscher-like retinopathy (PLR) is a rare, vision-threatening occlusive microvasculopathy. We report a rare case of unilateral PLR following the initiation of chemotherapy for recurrent cervical carcinoma. A 54-year-old female with recurrent carcinoma of the cervical vault presented with sudden, painless diminution of vision in the left eye (visual acuity: 2/60), five days post-initiation of chemotherapy with gemcitabine and bevacizumab. Fundus examination revealed multiple superficial hemorrhages, cotton wool spots, and Purtscher flecken with macular edema, initially diagnosed elsewhere as a combined central retinal artery and vein occlusion. Systemic laboratory workup was unremarkable. A diagnosis of chemotherapy-induced PLR secondary to localized thrombotic microangiopathy was established. The patient was managed conservatively with close oncological follow-up. Gemcitabine and bevacizumab can precipitate localized thrombotic microangiopathy leading to PLR. Precise funduscopic evaluation is essential to distinguish PLR from combined retinal vascular occlusions to prevent unnecessary interventions and guide appropriate multidisciplinary management.
