Journal of Current Ophthalmology
Volume:28 Issue: 2, Jun 2016

To present an overview on ultra-wide-field imaging in diabetic retinopathy.
A comprehensive search of the pubmed database was performed using the search terms of “ultra-wide-field imaging”, “ultra-wide-field fluorescein angiography” and “diabetic retinopathy”. The relevant original articles were reviewed.
New advances in ultra-wide-field imaging allow for precise measurements of the peripheral retinal lesions. A consistent finding amongst these articles was that ultra-wide-field imaging improved detection of peripheral lesion. There was discordance among the studies, however, on the correlation between peripheral diabetic lesions and diabetic macular edema.
Visualization of the peripheral retina using ultra-wide-field imaging improves diagnosis and classification of diabetic retinopathy. Additional studies are needed to better define the association of peripheral diabetic lesions with diabetic macular edema.

The efficacy and sufficiency of a healthcare system is directly related to the knowledge and skills of graduates working in the system. In this regard, many different assessment methods have been proposed to evaluate various skills of the learners. Video Observation of Procedural Skills (VOPS) is one newly-proposed method. In this study we aimed to compare the results of the VOPS method with the more commonly usedDirect Observation of Procedural Skills (DOPS).
In this prospective study conducted in 2012, all 10 ophthalmology residents of post graduate year 4 were selected for participation. Three months into training in the glaucoma ward, these residents performed trabeculectomy surgery on patients, and their procedural skills were assessed in real time by an expert via the DOPS method. All surgeries were also recorded and later evaluated via the VOPS method by an expert. BlandeAltman plot also was used to compare the two methods and calculating the mean and 95% limit of agreement.
Residents have been done a mean of 14.9 ± 3.5 (range 10e20) independent trabeculectomy before the assessments. DOPS grade was positively associated with number of independent trabeculectomy during glaucoma rotation (b¼0.227, p ¼ 0.004). The intra-observer reproducibility of VOPS measurements was 0.847 (95% CI: 0.634, 0.961). The mean VOPS grade was significantly lower than the mean DOPS grade (8.4 vs. 8.9, p ¼ 0.02). However, a good correlation was observed between the grades of VOPS and DOPS (r ¼ 0.89, p ¼ 0.001). BlandeAltman analysis demonstrated that all data points fell within the 95% limits of agreement (1.46, 0.46).
The present study showed that VOPS might be considered a feasible, valid, and reliable assessment method for procedural skills of medical students and residents that can be used as an alternative to the DOPS method. However, VOPS might underestimate DOPS in evaluating surgical skills of residents.

To describe the effect of prolonging the standard suction duration during laser assisted in-situ keratomileusis (LASIK) and its effect on flap thickness and hinge length using sub-Bowman keratomileusis (SBK) microkeratome.
Fifty-six eyes (28 patients) were included and divided into 2 groups; Group-A: eyes with flatter corneas (36 eyes, 18 patients) and mean keratometric readings ranging from 40.13 to 43.71 diopters (D). Group-B: eyes with steeper corneas (20 eyes, 10 patients) with mean keratometric readings ranging from 43.85 to 46.72 D. One-Use-Plus SBK microkeratome was used for flap creation. For right eyes, flap was created immediately once suction was built up. In left eyes, the surgeon waited for 10 s after suction was built up before flap creation. Flap hinge length and flap thickness were measured using surgical caliper and ultrasonic pachymetry, respectively.
Statistically significant differences were observed in corneal flap hinge size between right eyes versus left eyes, with a mean of 3.98 ± 0.48 vs. 3.78 ± 0.55 mm ( p Increasing suction duration increases flap hinge length and stabilizes the flap, especially in steeper corneas.

To investigate the effect of a lubricating drop on optical quality, tear film stability, and subjective symptoms in individuals wearing silicone hydrogel contact lens.
In this one-day, prospective single-center clinical study, Pre-lens Tear Deformation Time (PL-TDT), Root-Mean-Square (RMS) of Low Order Aberrations (LOA) and High Order Aberrations (HOA), individual twelve Zernike coefficients, and subjective symptoms were assessed in 43 volunteers (mean age 19.58 ± 1.63, 86 eyes) at 6 h after inserting the contact lens and then at 60 min after instilling a lubricating drop (Comfort drops, Avizor, Madrid-Spain).
PL-TDT, LOA-RMS, and HOA-RMS values measured before drop instillation were not significantly different with those measured after drop. None of the Zernike coefficients were significantly different after instilling lubricating drop. Statistically significant decrement in both frequency and severity values in blurry vision, dryness, discomfort, burning, itching, foreign body sensation, excessive blinking, and lacrimation were seen after drop instillation (all P Our results showed that although the lubricating drop did not improve the tear film stability and optical quality in the silicone hydrogel contact lens wearers, subjects experienced a subjective improvement.

This study reports the characteristics of corneal higher order aberrations (HOAs) in eyes with normal topographic pattern using the Pentacam scheimpflug system.
In this prospective, observational, comparative study, 165 eyes of 97 patients separated into five groups based on corneal topographic patterns were enrolled. All eyes received a comprehensive ophthalmologic examination including corneal tomographic analysis with the Pentacam system. Keratometry, corneal cylinder, and corneal aberrometric data were recorded and analyzed. Root mean square values (RMS) were calculated for corneal HOAs up to the 6th order, total coma, total trefoil, total spherical aberration, total tetrafoil, and higher order astigmatism. Evaluation of these data to discriminate between the five groups was assessed using the analysis of variance test by Generalized Estimation Equation Linear Model.
Corneal HOAs were found to be significantly higher for Asymmetric Bow Tie and Irregular groups than other groups (p ¼ Based on results in this study, there were a good correlation between corneal topographic pattern and corneal HOAs in normal eyes. These results indicate that the corneal HOAs values are largely determined by the topographic patterns. A larger sample size would perhaps have been beneficial to yield in more accurate outcomes.

To determine the dimensions of orbital entrance in unaffected bony orbit by computed tomography (CT) in a sample of Iranian population.
Radiologic features of 120 patients were gathered using standardized skull protocol by CT scan. We measured the distance between anterior lacrimal crest and orbital border of zygomatic bone, termed width, and the distance between the plane passing through the anterior orbital entrance to optic canal, termed depth, using horizontal sections of skull base CT scan. Sagittal sections were used to demonstrate the height, the distance between frontal and maxillary bone. Orbital index (height/width 100) was then calculated.
The mean values of orbital width, height, and depth were 28.49 ± 2.35 mm, 32.14 ± 1.57 mm, and 38.84 ± 3.90 mm, respectively. There was a significant difference in height (P ¼ 0.001), depth (P ¼ 0.004), and width (P ¼ 0.012) between the right and left orbits. The mean value of the orbital index was 88.65 ± 8.90 mm in this population.
The orbital index of this sample Iranian people is Mesoseme according to our study results, the expected characteristic of the white race. The right orbits are determined to be larger than the left ones.

Propose: A qualitative approach using semi-structured individual interviews was used to elicit common outdoor difficulties in individuals with visual impairment.
Interviews were recorded and then transcribed verbatim into text for thematic analysis. Twenty legally-blind individuals aged 34.25 ± 2.41 years with different etiologies were included in this study.
All participants had experienced some sort of difficulty in outdoor environments. The most important problems as perceived by the participants are installation of tactile ground surface indicators, unsafe sidewalks, existence of obstacles on sidewalks, difficulty reading bus numbers, disorientation, fear of falling, recognition of faces, inability to read street names, the presence of spaces between platforms and buses, walking into glass doors, crossing streets, and the risk of Arial barriers.
As a visually impaired person might say, sidewalks can be the most dangerous of places. Appropriate urban modification can be very beneficial.

The purpose of this study was to determine the factors associated with Pterygium, utilizing history and examination.
In this prospective case series study, a total of 1227 patients with Pterygium presenting at the Department of Ophthalmology, Chandka Medical College Hospital Larkana, Pakistan, from January 1997 to January 2015 were included. A standard proforma containing proposed risk factors was filled in for every patient. Clinical examination was performed on slit-lamp biomicroscope to confirm presence of pterygium.
Out of the total 1227 patients, 656 (53.46%) were males, and 571 (46.54%) were females. Mean age ± standard deviation was 53.12 years ± 15.85 years, and the age range was 20e79 years. 1063 (86.63%) patients belonged to areas with hot and dry weather, 421 (34.31%) patients had a positive family history for Pterygium, 740 (60.31%) patients had history of previous exposure to toxic chemicals, and 364 (29.67%) patients had dry eye.
This study points towards the simultaneous role of multiple risk factors including sun exposure, hot climate, toxic material exposure, familial transmission, and dry eye in association with pterygium.

To report a case of cytomegalovirus (CMV) retinitis in an immunocompetent adult patient.
A 61-year-old woman with proven CMV retinitis and no evidence of HIV or other underlying immunodeficiencies was referred.
She was referred with history of recent right eye visual loss. In fundus examination, she had signs of retinal vasculitis. After initial examination, she was found to have CMV retinitis documented by polymerase chain reaction (PCR) analysis of vitreous sample. She had neither underlying risk factor in any assessed work-up nor any concomitant disease in 10 months follow-up. She received intravitreal ganciclovir with good response to treatment.
Ophthalmologists should take into account infectious causes of retinal vasculitis before approaching anti-inflammatory or anti- VEGF therapy.