Faculty of Ophthalmology

A cross-sectional study of correlation of climatic droplet keratopathy with serum proteins, serum calcium and lipid profile

2026-05-16T05:59:55Z

A cross-sectional study of correlation of climatic droplet keratopathy with serum proteins, serum calcium and lipid profile K Vallabha, Vivea Naresh Nagdev, Keerti Gururaj Wali Background: Climatic Droplet Keratopathy (CDK) is a progressive corneal degeneration linked to environmental exposure and possibly systemic factors. This study investigates associations between CDK and serum protein levels, calcium levels, and lipid profiles in a semi-arid Indian population. Materials and Methods: A cross-sectional study involving 64 subjects (32 CDK patients and 32 controls) was conducted using detailed ophthalmic evaluations and serum biochemical testing. CDK grading was performed by slit-lamp biomicroscopy. Statistical analyses employed Chi-square and ANOVA tests. Results: CDK patients were predominantly male (71.9%, p=0.006), with a high proportion engaged in farming (59.4%). Serum calcium levels negatively correlated with CDK severity (p=0.015). HDL levels were significantly reduced in cases (p<0.001), while VLDL showed significant variation across CDK grades (p=0.011). Total protein, albumin, and A/G ratio did not differ significantly. Conclusion: CDK shows strong associations with hypocalcemia, and low HDL cholesterol. These findings support a multifactorial pathogenesis involving environmental stress and systemic metabolic factors. Early screening and public health interventions in vulnerable regions may reduce disease burden.

Corneal endothelial alterations in senile cataract with and without pseudoexfoliation: a comparative specular microscopy study

2026-05-16T05:46:27Z

Corneal endothelial alterations in senile cataract with and without pseudoexfoliation: a comparative specular microscopy study Sachin Tammannavar, Karishima Khilar, Ramya Karjol Background; Pseudoexfoliation syndrome (PXF) is an age-related systemic microfibrillopathy characterized by the deposition of fibrillar extracellular material in ocular tissues. It is associated with endothelial dysfunction, increased intraoperative complications during cataract surgery, and a higher risk of corneal decompensation. Evaluation of corneal endothelial status using specular microscopy is therefore crucial in patients with PXF. Objective; To evaluate and compare corneal endothelial cell density (ECD) and endothelial morphology using specular microscopy in senile cataract patients with and without pseudoexfoliation. Methods; This prospective, comparative study was conducted at Department of Ophthalmology, Andhra Medical College, Visakhapatnam, from January 2025 to January 2026. A total of 100 patients with senile cataract were included: 50 patients with pseudoexfoliation (PXF group) and 50 age-matched patients without pseudoexfoliation (control group). All patients underwent comprehensive ophthalmic evaluation including slit-lamp examination, intraocular pressure measurement, gonioscopy, and non-contact specular microscopy (Tomey EM 3000). Endothelial cell density (cells/mm²), coefficient of variation (CV%) indicating polymegathism, percentage of hexagonal cells (6A) indicating pleomorphism, and central corneal thickness (CCT) were recorded. Statistical analysis was performed using SPSS software; p < 0.05 was considered statistically significant. Results; The mean endothelial cell density was significantly lower in the PXF group (2180.20 ± 404.41 cells/mm²) compared to the control group (2695.86 ± 124.94 cells/mm²) (p < 0.0001). The mean coefficient of variation was higher in patients with PXF (40.90 ± 8.69) compared to controls (37.70 ± 3.99), indicating increased polymegathism. The mean percentage of hexagonal cells was significantly reduced in the PXF group (40.20 ± 5.44) compared to the control group (44.18 ± 3.98) (p < 0.001), demonstrating increased pleomorphism. Central corneal thickness was significantly lower in the PXF group (489.02 ± 25.14 µm) compared to controls (513.02 ± 31.43 µm). These findings indicate significant quantitative and qualitative endothelial alterations in patients with pseudoexfoliation. Conclusion; Senile cataract patients with pseudoexfoliation demonstrate significantly reduced endothelial cell density, decreased central corneal thickness, and altered endothelial morphology characterized by polymegathism and pleomorphism. Preoperative assessment with specular microscopy is essential in PXF patients to identify those at higher risk of corneal decompensation and to plan appropriate surgical strategies. Careful endothelial evaluation should be considered a mandatory preoperative step in cataract patients with pseudoexfoliation.

Clinical profile and fundus changes in pathological myopia: a prospective study from south india

2026-05-16T05:34:37Z

Clinical profile and fundus changes in pathological myopia: a prospective study from south india Sachin Tammannavar, Karishima Khilar, Ramya Karjol associated with significant visual morbidity due to structural changes in the posterior segment of the eye. With increasing prevalence, especially among younger populations, early identification of associated fundus changes and complications is essential for timely intervention and prevention of vision loss. Methods: This prospective study was conducted over a period of six months (January 2024 to June 2024). A total of 100 patients (200 eyes) with pathological myopia (refractive error > -6.0 D) were included. All patients underwent detailed ophthalmic evaluation including visual acuity assessment, slit-lamp examination, intraocular pressure measurement, A-scan biometry, keratometry, and fundus examination. Patients with abnormal corneal curvature and other ocular pathologies were excluded. Posterior segment changes and peripheral retinal degenerations were documented and analyzed. Results: The highest incidence of pathological myopia was observed in the 11–20 years age group (32%), with a female predominance (54%). Most patients had a refractive error between -6 D and -9 D (41.5%) and axial length ranging from 26 28 mm (34%). The majority of patients had best corrected visual acuity between 6/6 and 6/18 (60%). Common fundus findings included tessellated fundus (42%), temporal crescent (40%), peripapillary atrophy (25%), and posterior staphyloma (21%). Lacquer cracks were observed in 11% and Fuchs spots in 7.5% of cases. Peripheral retinal degeneration was most commonly lattice degeneration (5%). Complications such as retinal detachment (5%), primary open-angle glaucoma (5%), and retinitis pigmentosa (4%) were also noted. Conclusion: Pathological myopia is associated with a high prevalence of degenerative fundus changes, particularly in eyes with higher refractive error and axial length. Early detection through meticulous fundus examination and regular follow-up is crucial to prevent vision-threatening complications and preserve visual function.

Clinical profile of patients with isolated lateral rectus palsy in adults

2026-05-16T04:54:19Z

Clinical profile of patients with isolated lateral rectus palsy in adults Ramya Karjol, Renuka Kattimani , Sachin Tammannavar Background Isolated lateral rectus (LR) palsy is a common cranial nerve palsy with a variety of causes. Horizontal diplopia is frequently caused by isolated LR palsy, a common cranial nerve palsy in adults. The abducens nerve is vulnerable to a variety of vascular, inflammatory, traumatic, viral, and compressive diseases because of its lengthy intracranial journey. This study aims to describe the clinical profile, etiological distribution, and outcomes in adults with isolated LR palsy. Methodology This retrospective observational study included 29 consecutive adults diagnosed with isolated LR palsy. Demographic characteristics, clinical presentation, investigation findings, etiological diagnoses, and recovery outcomes during follow-up were systematically recorded and analyzed using descriptive statistical methods. Results The mean age was 48.17 years (range = 19-85 years), with a male-to-female ratio of 15:14. Etiologies included diabetes-related microvascular ischemia in seven (24.1%) patients, hypertension-related microvascular ischemia in seven (24.1%) patients, infection with inflammation in four (13.8%) patients, trauma in four (13.8%) patients, idiopathic causes in two (6.9%) patients, tumor in one (3.4%) patient, cavernous sinus thrombosis in three (10.3%) patients, and microvascular ischemia associated with both diabetes mellitus and hypertension in one (3.4%) patient. At the last follow-up, 19 (65.5%) patients had complete recovery, two (6.8%) had partial recovery, one (3.4%) had no recovery, and seven (24.1%) were lost to follow-up. Conclusions Microvascular ischemia associated with diabetes mellitus and hypertension was the leading cause of isolated LR palsy in adults. Most patients demonstrated improvement during follow-up, whereas traumatic and compressive etiologies showed relatively poorer outcomes. Careful systemic evaluation and targeted neuroimaging are important in patients with atypical presentations or suspected non-microvascular causes. These findings emphasize the importance of systematic clinical assessment, etiological evaluation, and follow-up in adults presenting with isolated LR palsy.