Ashok Kumar Grover

Traumatic cataract surgery with intraocular lens implantation in children.

We evaluated our experience of intraocular lens implantation in 22 children with uniocular traumatic cataract. Good visual acuity was achieved in a large proportion of the children despite associated corneal opacities and several intraoperative and postoperative complications. Our study suggests that intraocular lens implantation may have a major role in management of monocular cataracts in children.

Congenital Eyelid Colobomas in 51 Patients

PURPOSE To review the clinical observations in the management of congenital eyelid coloboma. METHODS Fifty-one cases of congenital eyelid colobomas including the functional and cosmetic rehabilitation of patients who were treated over a period of 18 years with an average follow-up of 4.7 years were retrospectively reviewed. RESULTS Thirty-eight patients had an upper eyelid coloboma and 13 patients had a lower eyelid coloboma. Systemic associations included Goldenhar syndrome and Treacher-Collins-Franceschetti syndrome. Twenty-two patients with upper eyelid colobomas underwent surgery by direct apposition, eyelid sharing procedures, or a lateral rotation flap. Lower eyelid colobomas were repaired in 4 patients. CONCLUSION Gratifying cosmetic and functional results could be achieved in all 26 patients who underwent surgery.

Multiple displacement amplification as a pre‐polymerase chain reaction (pre‐PCR) to detect ultra low population of Ralstonia solanacearum (Smith 1896) Yabuchi et al. (1996)

Aims:  To develop a reliable and sensitive protocol for detection of Ralstonia solanacearum using MDA‐PCR (Multiple displacement amplification–PCR amplification).

Morning glory anomaly with bilateral choroidal colobomas in a patient with Goldenhar's syndrome.

A child with Goldenhars syndrome, bilateral choroidal colobomas, and a morning glory anomaly of the optic disk in one eye is described. Bilateral posterior segment anomalies associated with Goldenhars syndrome are rare. An association between the morning glory anomaly and Goldenhars syndrome has not been previously reported.

A national curriculum for ophthalmology residency training

We present a residency curriculum for Ophthalmology in India. The document derives from a workshop by the All India Ophthalmological Society (AlOS) which adapted the International Council of Ophthalmology residency curriculum and refined and customized it based on inputs by the residency program directors who participated in the work shop. The curriculum describes the course content, lays down the minimum requirements of infrastructure and mandates diagnostic and therapeutic procedures required for optimal training. It emphasises professionalism, management, research methodology, community ophthalmology as integral to the curriculum. The proposed national ophthalmology residency curriculum for India incorporates the required knowledge and skills for effective and safe practice of ophthalmology and takes into account the specific needs of the country.

Residency training in India: Time for a course correction

A study of medical colleges by the Academic and Research Committee of the All India Ophthalmological Society (AIOS) in 2000 provided evidence of huge gaps in ophthalmic infrastructure and the lack of subspecialty services.[3] Another survey of the medical colleges in India in 2005 pointed to the deficiencies in academics and research. It showed that 20% of the institutions had no ophthalmic journals, 60% had two or less international journals, and only 8.6% had > 5 international publications in the last 3 years.[4] A study from the state of Andhra Pradesh revealed that there was no significant change in the residency training in eight medical colleges in two evaluations 8 years apart (1998 and 2006) after provision of modern instrumentation and training. The intervention did not make a difference to the quality of postgraduate training or help to make the residents confident of setting up their practice.[5]

Eyelid Trauma: General Considerations

Management of periorbital trauma is aimed at preservation of vision, prevention of ocular complications, and restoring the damaged structures. Correct management of eyelid injuries is essential to achieve the best cosmetic and functional outcome. Due to complex eyelid anatomy, the treatment of any periocular injury including even a small laceration requires a profound knowledge of anatomy and plastic reconstructive principles. The methods used for reconstruction are based on the site and extent of the defect as well as the cosmetic requirements. Some peculiarities in this area must be considered before undertaking any surgical repair.

Systemic Management in Orbital and Adnexal Emergencies

A thorough systemic assessment and maintaining vitals are crucial in every trauma patient. Only once the patient is stable, the ocular and periorbital injuries can be addressed. An understanding of basic life support management as well as the investigations required is important for every practitioner.

Management of nasolacrimal duct obstruction in children: How is it changing?

Nasolacrimal duct obstruction (NLDO) in children is congenital in most cases. Noncanalization of the inferior caudal end of the duct is the most common cause. Spontaneous resolution of the obstruction occurs in 96% of affected children in the first year in the natural course and conservative management is the mainstay.[1] Traditional treatment is a hydrostatic massage of the sac. Although there are proponents of early probing, most surgeons prefer to delay their intervention to the age of about one year. Success rates for primary probing are up to 97% during the first year.[2] Good success rates have been reported in older children as well (88% at age 12–101 months, mean 33 months).[3] Factors implicated in failure of probing include improper technique, late age of probing, anatomical variations (complex NLDO), inferior turbinate hypertrophy/ impaction, or associated nasal pathology.[4]