BACKGROUND: Pterygium is very common in India and is usually removed by limbal conjunctival autograft transplantation (LCAT), which, despite being the first-line therapy, is still associated with recurrences of up to 18%. OBJECTIVES: To compare the safety and efficacy of topical cyclosporine A (CsA) and interferon (IFN) alpha-2b in the prevention of postoperative recurrence of pterygium. METHODS: A total of 40 patients with primary pterygium were randomized into two equal groups, Group C and Group I. Both the groups underwent LCAT, with Group C kept on topical cyclosporine 0.05% (CsA) 4 times daily and Group I on topical IFN alpha 2b 0.2 million IU 4 times daily postoperatively for 3 months. Pre- and posttreatment best-corrected visual acuity (BCVA), recurrence, and complications were assessed at day 1, week 1, 1 month, and 3 months. RESULTS: The mean preoperative BCVA of 0.51 ± 0.18 and 0.51 ± 0.23 improved to 0.13 ± 0.13 and 0.13 ± 0.13 in Group C and Group I, respectively, after 3 months of treatment (P < 0.0001). Recurrence was seen in 2 cases in Group C and in 1 case in Group I at 3 months. No significant complications occurred in either of the groups. CONCLUSION: Topical CsA and IFN Alpha-2b are newer efficacious adjuvants with LCAT for prevention of postoperative pterygium recurrence.

Purpose: Prolonged postoperative topical corticosteroids are commonly given after pediatric cataract surgery to control inflammation. This study was undertaken to compare the efficacy, safety, and compliance of postoperative topical steroids and adjunctive intracameral (I/C) triamcinolone acetonide (tricort) and posterior subtenon (PST) triamcinolone in modulating postoperative inflammation after surgery. Methods: Forty-eight eyes of children with pediatric cataract between the ages of 5 and 10 years were randomized into three equal groups (T, I, S) before surgery. Group T received postoperative topical 1% prednisolone tapered over 4 weeks; Group I received adjunctive intraoperative I/C 1.2 mg/0.03 ml tricort and topical 1% prednisolone for 2 weeks postoperatively, and Group S received a single 0.5 ml (40 mg/ml) PST tricort without topical steroids. Signs of inflammation, intraocular pressure (IOP), and central corneal thickness were assessed at day 1, week 1, week 3, week 6, and week 12 postoperatively with optical coherence tomography (OCT) macula to rule out cystoid macular edema at the sixth and 12th weeks postoperatively. Results: Posterior synechiae were present in two eyes out of 16 in groups T and I, which resolved. Severe anterior chamber cells were present in four eyes out of 16 in group T, in two eyes in group I, and in one eye in group S, which resolved. All groups had comparable pre- and postoperative IOP. Conclusion: In pediatric cataracts, outcomes were better with PST tricort and the adjunctive I/C tricort compared to postoperative topical prednisolone, for modulating postoperative inflammation.

Background: Postpartum fungal endogenous endophthalmitis is an extremely rare condition, particularly in young healthy women. It can lead to permanent vision loss. Findings: We report a case of a 26-year-old lactating mother with a history of decreased vision in her right eye after a normal vaginal delivery. She was diagnosed with endogenous endophthalmitis caused by a very rare fungus, Candida ciferrii, on vitreous biopsy, 2 months after the initial presentation. After vitrectomy, she was treated with oral antifungal therapy and, subsequently, her visual acuity improved to 20/30 with quiet eye after 6 months of follow-up. Conclusion: Postpartum fungal endogenous endophthalmitis can present as a diagnostic and therapeutic challenge. It warrants early diagnosis and management.

PURPOSE: Conventionally, congenital nasolacrimal duct obstruction (NLDO) has been treated as an entity with no bearing on development of visual acuity and routine refraction is not done considering the volume of patients in a in a developing Asian country like India. This research was designed to study the prevalence of amblyogenic refractive error in patients with congenital NLDO, as compared to an age-matched control group, in a developing country. METHODS: In this study, 89 patients with congenital NLDO and 78 patients as age matched controls, less than 4 years of age were included at a tertiary care centre in India. All underwent a complete ocular examination and risk factors for amblyogenic refractive error were noted based on the AAPOS guidelines. RESULTS: There was no gender predisposition and no significant difference between the two groups in terms of mode of delivery, orthoptic check-up, keratometry, axial length, fundus or anterior segment examination. Amblyogenic refractive error, as defined by the AAPOS guidelines, was found in 18 (20.5%) patients in the case group compared to 3 (3.8%) in the control group, and this was as follows: astigmatism in 10, anisometropia in 5, hyperopia in 3 subjects, and myopia in 1. These risk factors were not greater in children with unilateral NLDO compared to bilateral NLDO, but both were greater than their control group. There was also no significant difference found between the two groups in terms of distribution of anisometropia. CONCLUSIONS: The prevalence of amblyogenic refractive error in congenital NLDO was significantly higher than in the control group. Hence, a thorough evaluation is warranted in cases of congenital NLDO for early detection amblyogenic refractive error.