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  1. Abu Bakar NF, Chen AH
    Indian J Ophthalmol, 2014 Feb;62(2):141-4.
    PMID: 24008790 DOI: 10.4103/0301-4738.116481
    Children with learning disabilities might have difficulties to communicate effectively and give reliable responses as required in various visual function testing procedures.
  2. Agarwal R, Agarwal P
    Indian J Ophthalmol, 2012 Jul;60(4):255-61.
    PMID: 22824592 DOI: 10.4103/0301-4738.98700
    Glaucoma, a neurodegenerative disease, is currently being treated by modulation of one of its primary risk factors, the elevated intraocular pressure. Newer therapies that can provide direct neuroprotection to retinal ganglion cells are being extensively investigated. Tumor necrosis factor-α, a cytokine, has been recognized to play an important role in pro and antiapoptotic cellular events. In this paper we review the relevant literature to understand (1) The association of increased expression of tumor necrosis factor-α with glaucomatous neurodegeneraion, (2) Modulation of tumor necrosis factor-α expression by exposure to various risk factors of glaucoma, (3) Downstream cellular signaling mechanisms following interaction of tumor necrosis factor-α with its receptors and (4) Role of tumor necrosis factor-α as a possible target for therapeutic intervention in glaucoma. Literature was reviewed using PubMed search engine with relevant key words and a total of 82 English language papers published from 1990 to 2010 are included in this review.
  3. Asif JA, Pohchi A, Alam MK, Athar Y, Shiekh RA
    Indian J Ophthalmol, 2014 Nov;62(11):1098-1100.
    PMID: 25494256 DOI: 10.4103/0301-4738.146756
  4. Bhandary S, Khanna R, Rao KA, Rao LG, Lingam KD, Binu V
    Indian J Ophthalmol, 2010 12 16;59(1):41-5.
    PMID: 21157071
    AIM: Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia.

    MATERIALS AND METHODS: This observational study was conducted on attendants who accompanied patients (n = 400) visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between August and October 2007. The participants answered a questionnaire (Malay and English versions) which included demographic profile, awareness of eye donation, knowledge regarding facts of eye donation, and willingness to donate eyes. Univariate and multivariate logistic regression was performed at 5% level of significance.

    RESULTS: Awareness of eye donation was observed in 276 (69%) participants. Multivariate analysis showed that awareness was more among females when compared to males (P = 0.009). Of the 276 participants who were aware of eye donation, only 34.42% were willing to donate eyes. Willingness was more among the Indian race (P = 0.02) and males (P = 0.02). Educational status did not influence the willingness to donate eyes.

    CONCLUSIONS: Although majority of participants were aware of eye donation, willingness to donate eyes was poor.

  5. Chen AH, Norazman FN, Buari NH
    Indian J Ophthalmol, 2012 Mar-Apr;60(2):101-4.
    PMID: 22446903 DOI: 10.4103/0301-4738.90489
    BACKGROUND: Visual acuity is an essential estimate to assess ability of the visual system and is used as an indicator of ocular health status.
    AIM: The aim of this study is to investigate the consistency of acuity estimates from three different clinical visual acuity charts under two levels of ambient room illumination.
    MATERIALS AND METHODS: This study involved thirty Malay university students aged between 19 and 23 years old (7 males, 23 females), with their spherical refractive error ranging between plano and -7.75D, astigmatism ranging from plano to -1.75D, anisometropia less than 1.00D and with no history of ocular injury or pathology. Right eye visual acuity (recorded in logMAR unit) was measured with Snellen letter chart (Snellen), wall mounted letter chart (WM) and projected letter chart (PC) under two ambient room illuminations, room light on and room light off.
    RESULTS: Visual acuity estimates showed no statistically significant difference when measured with the room light on and with the room light off (F1,372 = 0.26, P = 0.61). Post-hoc analysis with Tukey showed that visual acuity estimates were significantly different between the Snellen and PC (P = 0.009) and between Snellen and WM (P = 0.002).
    CONCLUSIONS: Different levels of ambient room illumination had no significant effect on visual acuity estimates. However, the discrepancies in estimates of visual acuity noted in this study were purely due to the type of letter chart used.
  6. Das S, Singh V, Saurabh K
    Indian J Ophthalmol, 2020 06;68(6):1209-1211.
    PMID: 32461485 DOI: 10.4103/ijo.IJO_1681_19
    Sports-related ocular traumas may be rare, but can have devastating and disabling consequences. The causes of eye-related injuries depend on the type of sports popular in a particular area or country. Badminton is a popular sport played by all age groups and socioeconomic segments and is popular in many parts of the world. It is most popular in South-East Asia, accounting for two-thirds of all ocular sports injury in Malaysia. In India, badminton has become quite popular in recent years. Shuttlecocks in badminton have been shown to be responsible for a high number of outpatient ocular sports-related, mostly blunt injuries. We report an unusual case of penetrating ocular injury due to a feather shuttlecock and its surgical management.
  7. Deva JP, Ngeow YF, Zin T
    Indian J Ophthalmol, 2023 Jun;71(6):2443-2447.
    PMID: 37322657 DOI: 10.4103/IJO.IJO_2894_22
    PURPOSE: This case-control study aims to examine possible associations of VSX1 exon3 gene variants with the development of keratoconus (KC) in Malaysian patients.

    METHODS: A case-control study was done on 42 keratoconus cases, 127 family member controls, and 96 normal controls.

    RESULTS: Three gene variants, p.A182A, p.P237P, and p.R217H showed significant associations with keratoconus (P < 0.05). While p.A182A and p.P227P were more prevalent than in the family and normal controls (OR 3.14-4.05), the reverse was observed with p.R217H (OR 0.086-1.59). With Haploview analysis, p.A182A and p.P237P were shown to be in linkage disequilibrium (LD) (LOD (logarithm of the odds score) score of 2.0, r2 of 0.957, and 95% confidence interval (CI) of 0.96-1.00).

    CONCLUSION: The study results suggest that the p.A182A and p.P237P variants could have contributed to the development of keratoconus in some Malaysians and that these two variants are likely to be co-inherited. In contrast, the p.R217H variant appeared to confer some protection against the development of keratoconus.

  8. Fogla R, Gujar P, Law M
    Indian J Ophthalmol, 2022 Feb;70(2):653-654.
    PMID: 35086256 DOI: 10.4103/ijo.IJO_1986_21
    The COVID-19 pandemic has brought a radical change in safety measures in outpatient clinics. The use of face masks by patients and healthcare workers has become a mandatory norm. Exhaled air with a face mask often follows an upward route. The warm exhaled air leads to fogging of 90/78D lens during fundus examination, hampering visualization. This can be prevented by the use of a simple yet innovative DIY adapter for a 90/78D lens, which can be made using simple household items such as PVC pipes or water hose pipes.
  9. Gharamah AA, Moharram AM, Ismail MA, Al-Hussaini AK
    Indian J Ophthalmol, 2014 Feb;62(2):196-203.
    PMID: 24008795 DOI: 10.4103/0301-4738.116463
    This work was conducted to study the ability of bacterial and fungal isolates from keratitis cases in Upper Egypt to produce enzymes, toxins, and to test the isolated fungal species sensitivity to some therapeutic agents.
  10. Goh WN, Mustapha M, Zakaria SZS, Bastion MC
    Indian J Ophthalmol, 2022 08;70(8):3026-3032.
    PMID: 35918966 DOI: 10.4103/ijo.IJO_3198_21
    Purpose: To determine the effectiveness of laser vitreolysis in terms of contrast sensitivity function (CSF) and vision-related quality of life (VRQol) for symptomatic floaters due to posterior vitreous detachment (PVD).

    Materials: This is an interventional study that involved 57 eyes of 45 patients with symptomatic floaters for more than 3 months. Patients underwent one to three sessions of vitreolysis via Neodymiun-doped Yttrium Aluminum Garnet (Nd:YAG) laser. We examined the CSF using the computer programs Freiburg Acuity and Contrast Test (FrACT) and VRQoL survey using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) before, and 1 month after, vitreolysis.

    Results: Twelve patients had both eyes lasered and 33 patients had one eye lasered. The mean CSF improved from 3.20 ± 0.85%W to 2.64 ± 0.63%W 1 month after vitreolysis. Each use of the laser showed a significant mean difference in CSF (%W) as analyzed by paired t-test before and after the first laser (0.29 ± 0.49%W [P ≤ 0.001]); after the first and second laser (0.35 ± 0.53%W [P = 0.01]); and after second and third laser (0.21 ± 0.31%W [P = 0.02]). There was improvement in the median of four subscales in NEI VFQ-25 scores post treatment: general vision (z = -3.30, P = 0.001), near activity (z = 3.396, P = 0.001, distance activity (z = -2.788, P = 0.005), and mental health (z = -2.219, P = 0.026). The mean scores increased to 79.55 ± 9.45 from the baseline 75.06 ± 9.69 (P ≤ 0.001). No adverse events were recorded 1 month after the laser treatments.

    Conclusion: Vitreolysis by Nd:YAG laser improved the CFS and VRQoL in symptomatic PVD patients.

  11. Khanna RK, Mokhtar E
    Indian J Ophthalmol, 2008 8 20;56(5):429-30.
    PMID: 18711278
    To describe use of a locally processed bovine pericardium (BP) to cover a large central corneal perforation following alkali injury and discuss postoperative outcome. A 27-year-old Malay male patient presented two weeks after alkali splashed in his left eye while working. A clinical diagnosis of left central corneal ulcer with limbal ischemia following alkali injury with secondary infection was made. After failed medical therapy, we performed a Gunderson conjunctival flap under local anesthesia that retracted after one week and resulted in a large central corneal perforation with surrounding stromal thinning. The perforation was covered with a locally processed BP xenograft (Lyolemb) supplied by the National Tissue Bank, University Sains Malaysia. Nine months follow-up showed a well-taken graft without any exposure/dehiscence and minimal inflammation. Amniotic membrane transplantation when used as a patch graft needs an urgent tectonic graft to promote corneal stability in patients with severe corneal thinning. The use of processed BP can be a viable option in treating such cases.
  12. Lau LL, Lung CK, Ahmad SS
    Indian J Ophthalmol, 2015 Nov;63(11):856-8.
    PMID: 26669339 DOI: 10.4103/0301-4738.171969
    A 34-year-old patient with a swelling over the upper eyelid for nearly 1 year was seen in our clinic. The history, examination and investigations were suggestive of a benign lacrimal gland tumor. The tumor and lacrimal gland were resected. Subsequent histopathological examination revealed the tumor was a primary ductal adenocarcinoma of the lacrimal gland. This is a very rare tumor with less than half a dozen cases reported so far. This case report is being presented to highlight an unusual presentation of this rare malignancy.
  13. Looi SY, Bastion MC, Leow SN, Luu CD, Hairul NMH, Ruhaslizan R, et al.
    Indian J Ophthalmol, 2022 Jan;70(1):201-209.
    PMID: 34937239 DOI: 10.4103/ijo.IJO_473_21
    Purpose: There are no effective treatments currently available for optic nerve transection injuries. Stem cell therapy represents a feasible future treatment option. This study investigated the therapeutic potential of human umbilical cord-derived mesenchymal stem cell (hUC-MSC) transplantation in rats with optic nerve injury.

    Methods: Sprague-Dawley (SD) rats were divided into three groups: a no-treatment control group (n = 6), balanced salt solution (BSS) treatment group (n = 6), and hUC-MSCs treatment group (n = 6). Visual functions were assessed by flash visual evoked potential (fVEP) at baseline, Week 3, and Week 6 after optic nerve crush injury. Right eyes were enucleated after 6 weeks for histology.

    Results: The fVEP showed shortened latency delay and increased amplitude in the hUC-MSCs treated group compared with control and BSS groups. Higher cellular density was detected in the hUC-MSC treated group compared with the BSS and control groups. Co-localized expression of STEM 121 and anti-S100B antibody was observed in areas of higher nuclear density, both in the central and peripheral regions.

    Conclusion: Peribulbar transplantation of hUC-MSCs demonstrated cellular integration that can potentially preserve the optic nerve function with a significant shorter latency delay in fVEP and higher nuclear density on histology, and immunohistochemical studies observed cell migration particularly to the peripheral regions of the optic nerve.

  14. Sailoganathan A, Osuobeni EP, Siderov J
    Indian J Ophthalmol, 2018 05;66(5):634-640.
    PMID: 29676304 DOI: 10.4103/ijo.IJO_1074_17
    Purpose: The purpose of this study to develop and calibrate a new Hindi logarithm of the minimum angle of resolution (logMAR) visual acuity chart.

    Methods: A new Hindi visual acuity chart was designed to logMAR specifications using Hindi optotypes experimentally selected to have similar relative legibility under equivalent spherical and cylindrical defocus. The chart calibration study was carried out in a large clinical setup in India. Participants who were literate in English and Hindi participated in the study. Visual acuity was measured with the new Hindi logMAR chart and a modified ETDRS (m-ETDRS) logMAR chart. The method of presentation was randomized between the charts. Repeat visual acuity was measured on a subsequent day with a second version of the Hindi logMAR chart.

    Results: The Hindi logMAR chart correlated highly with the m-ETDRS logMAR chart (r2 = 0.92); however, the mean visual acuity difference (Hindi logMAR-m-ETDRS logMAR) was nearly one and half lines (0.13 logMAR, 95% confidence interval [CI] = ±0.15 logMAR). The Hindi logMAR chart also proved to be highly repeatable (r2 = 0.99; mean difference 0.005, 95% CI = ±0.04 logMAR).

    Conclusion: This study reports the first standardized visual acuity chart developed in Hindi incorporating equal letter legibility and logMAR chart design features. The Hindi logMAR visual acuity chart provides a valid and repeatable tool for the measurement of visual acuity in native Hindi language speakers. Future use of the new Hindi chart should incorporate an increase in optotype size of 0.13 logMAR.

  15. Shriwas SR, Kinzha AZ
    Indian J Ophthalmol, 1993 Oct;41(3):129-30.
    PMID: 8125546
  16. Siuw CP, Tan SW, Abdul Wahid AB, Vasudevan S
    Indian J Ophthalmol, 2016 Mar;64(3):238-41.
    PMID: 27146939 DOI: 10.4103/0301-4738.181748
    A 40-year-old man presented with right eye axial proptosis and ophthalmoplegia for 3 months. Imaging study showed a right intraconal mass with the erosion of the orbital floor. Incisional biopsy revealed mucoepidermoid carcinoma. Nasal endoscopy was normal and systemic tumor screening was negative for a primary source. The patient underwent right orbital exenteration, uncinectomy, nasal and maxillary mucosal biopsy. Malignant cells were found present in the mucosa of maxillary sinus roof and uncinate bone. The postoperative positron emission tomography scan showed residual active lesion in right orbital apex and maxilla but no primary lesion elsewhere. The patient subsequently underwent 35 cycles of postoperative radiotherapy. Primary mucoepidermoid carcinoma of the orbit is rare and typically arises from the lacrimal gland or sac. Those tumors not arising from lacrimal apparatus should be presumed metastatic in origin, and the thorough systemic survey should be undertaken in the search for the primary tumor.
  17. Thevi T, Abas AL
    Indian J Ophthalmol, 2017 Oct;65(10):920-925.
    PMID: 29044054 DOI: 10.4103/ijo.IJO_512_17
    Traumatic endophthalmitis is a devastating condition that can occur following an open globe injury and result in loss of vision. The use of prophylactic antibiotics is empirical as most surgeons fear complications associated with the same. No systematic review has been performed in English on the role of intravitreal/intracameral antibiotics in preventing traumatic endophthalmitis. We searched for randomized controlled trials and controlled clinical trials comparing intracameral/intravitreal antibiotics with placebos on PubMed, Google Scholar, Science Direct, and Cochrane Library using keywords open globe/trauma/penetrating/perforating injuries endophthalmitis. The last search was on 5 May 2017. We included patients of all ages with open globe injuries who received intracameral/intravitreal antibiotics, regardless of the dose. Quality of the trials was assessed using Cochrane collaboration tools to assess the risk of bias. The main outcome measures were endophthalmitis and visual acuity. We included three trials. Overall, intravitreal/intracameral antibiotics were noted to significantly reduce the occurrence of endophthalmitis in open globe injuries (relative risk [RR] 0.19, 95% confidence interval [CI] 0.06-0.57). The use of intravitreal/intracameral antibiotics did not have an effect in improving visual acuity (RR 1.17, 95% CI 0.61-2.23). Two trials (Narang 2003; Soheilan 2001) were observed to have no significant effect on visual acuity while another trial (Soheilan 2007) did not list visual acuity as part of its objectives. Intracameral/intravitreal antibiotics reduce the risk of endophthalmitis in open globe injuries; although, there was no improvement in the visual acuity. We, therefore, recommend the use of intravitreal/intracameral injections in open globe injuries to prevent this devastating complication.
  18. Thevi T, Maizura Z, Abas AL
    Indian J Ophthalmol, 2017 Jan;65(1):24-29.
    PMID: 28300736 DOI: 10.4103/ijo.IJO_452_16
    INTRODUCTION: As in all surgeries, complications during cataract surgery are unavoidable and cause distress to the surgeon and the patient. This study was conducted to know the factors contributing to complications in our settings, to be able to counsel patients about complications and outcomes and to reduce litigations.

    MATERIALS AND METHODS: The secondary data analysis was conducted using the National Eye Database from 2007 to 2014. Demographic features, ocular comorbidities, technique of surgery, grade of surgeons, types of intraoperative complications, and reasons for not obtaining good visual acuity following intraoperative complications were studied. Statistics was done using Statistical Package for Social Sciences version 20.

    RESULTS: Out of 12,992 eyes, 6.1% had intraoperative complications. The highest rate of complications was when more trainees (medical officers [MOs] and gazetting specialists) operated. Posterior capsule rupture (PCR) was the most common complication followed by vitreous loss and zonular dehiscence. Those aged below 40 years had more complications (P < 0.05), and females had more complications. Ethnicity did not affect complications. Pseudoexfoliation was the only comorbidity causing complications (P < 0.05). Phacolytic lenses had 8.118 times the odds of getting intraoperative complications. MOs and gazetting specialists got more complications. Good outcomes were obtained in cases without complications and those operated by specialists. High astigmatism was the main reason for poorer outcomes.

    CONCLUSION: Intraoperative complications were caused mostly by less experienced doctors and had poorer outcomes. Age below 40 years, females, the presence of pseudoexfoliation and phacolytic lenses had more complications. PCR was the most common complication.

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