Browsing by Author "Rajendra P. Maurya"

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A rare case of Radius Maumenee syndrome with unilateral open angle glaucoma
(IP Innovative Publication Pvt. Ltd., 2024) Rakesh Shakya; Navjot Singh Ahluwalia; Rajendra P. Maurya; Nidhi Gupta; B.K. Jain; Chintan Shah
Elevated episcleral venous pressure (EEVP) is a rare but important cause of raised intraocular pressure. The resultant glaucoma is often severe and refractory to routine anti glaucoma treatment. Usually it occurs due to arteriovenous fistulas or venous congestion. This entity is important to detect as it may be associated with serious pathologies like retrobulbar tumor, cavernous sinus thrombosis, mediastinal tumor to name a few. EEVP is considered idiopathic after ruling out such disorders. Here, we have described idiopathic EEVP also known as Radius-Maumenee syndrome along with a detailed diagnostic and therapeutic approach of management. © 2024 Author(s), Published by Innovative Publication.
A report on intra orbital foreign body presenting as a chronic discharging sinus
(IP Innovative Publication Pvt. Ltd., 2020) Syeed Mehbub Ul Kadir; Rajendra P. Maurya
The visual loss due to retained orbital foreign body may be associated with the ruptured globe, traumatic optic neuropathy, and orbital fracture. Metallic foreign body is more common than non-metallic foreign body. A young male are commonly affected by an orbital foreign body. Our aim is to describe a case report on retained orbital foreign bodies of a young male patient. The presenting feature was chronic discharging sinus. CT scan confirmed the organic foreign body in the orbit. MRI may be done as adjunct to CT scan of the orbit in the cases of wooden foreign body. Surgical extraction was made for two times. A high index of suspicion is mandatory for the suspected case of orbital foreign body. Multiple pieces of wooden foreign may be found. © 2020 Innovative Publication, All rights reserved.
Association of sex hormone with age related macular degeneration
(IP Innovative Publication Pvt. Ltd., 2022) Rajendra P. Maurya
[No abstract available]
Cataract surgery clinical features, treatment and operational difficulties in management of cluster endophthalmitis
(IP Innovative Publication Pvt. Ltd., 2024) Rishabh Rathi; Rimpi Rana; Nitin Nema; Rajendra P. Maurya; Neeraj Gaur; Amisha Jain; Siddharth Patel; Abha Verma; Vaibhavi Subedar
Background: Cataract surgery is the most common ophthalmic surgery performed. Postoperative endophthalmitis is a rare but devastating situation for both patient and doctor. Cluster endophthalmitis is defined as five or more cases of endophthalmitis occurring on a particular day in a single operating room at one centre. Early diagnosis and appropriate management can salvage the affected eye. There are various factors that determine the prognosis in endophthalmitis. Polymicrobial etiology, family support, accessibility to health services, time-lapsed between onset of symptoms and initiation of treatment play an important role in final visual outcome. Purpose: To evaluate clinical features, management and final outcome in 64 cases of cluster endophthalmitis, and to identify the operational difficulties in managing cluster endophthalmitis in eye camp setting. Materials and Methods: This is a retrospective study done in 64 out of 94 patients, operated for cataract surgery in an eye camp setting, who presented with features of endophthalmitis. The demographic details, clinical features at presentation and management were evaluated from medical records. Assessment of problems faced by the patients during this period was done on the basis of detailed history given by the patient. Further, the reason for these operational difficulties were discussed with camp organizers. Results: Out of 64 patients there were 31(48.4%) males and 33(51.6%) female. Mean age of patients was 60 ± 15.3 years. The patients presented between postoperative day 7t h to 30t h. Visual acuity of all 64(100%) patients was poor where 59(92.2%) cases ranged between hand movement to perception of light while 5(7.8%) denied perception of light. The cultures were positive in 43(67.18%) cases out of 64 patients. The cultures reported with polymicrobial etiology with fungal growth in 31(48.43%) patients while 12(18.75%) cases showed bacterial growth. Management was done on the basis of Endophthalmitis vitrectomy study (EVS) guidelines. Only 6(9.37%) cases showed improvement in vision from baseline although all 64(100%) cases showed clinical and symptomatic improvement at the time of discharge. There was delay in presentation as no patient reported in 1st postoperative week. 31(48.4%) patients reported in 2nd post-operative week causing delay due to attitudinal problems. 19(29.6%) cases reported in 3r d week which was due delay in transportation and 14(21.8%) cases reported in 4t h week due to illiteracy and neglect. Conclusion: Cluster endophthalmitis can be prevented by taking aseptic precautions. Delay in initiation of treatment results in poor visual outcome. However, quick and timely decision helps in early intervention which provides a better chance to salvage eye and vision. There are certain modifiable factors in camp surgery which should be addressed properly to improve the final outcome. © 2024 Author(s).
Combined intraocular and oculofacial surgeries
(IP Innovative Publication Pvt. Ltd., 2024) Srushti Bagde; Saptagirish Rambhatla; V.S. Shashidhar; Samya Mujeeb; Rajendra P. Maurya
Background: Traditionally, a ‘combined surgery’ for ophthalmologists includes combined cataract extraction with other intraocular surgeries. However, literature is lacking on oculofacial procedures (eyelid, brow lift and facial surgery) combined with cataract extraction. Materials and Methods: With this study, we aim to analyse the possibility and feasibility of simultaneous cataract and Oculoplastic procedures. Patients with operable cataracts and non-infective oculoplastic lesions, consenting to undergo simultaneous procedures were included in the study. We performed combined cataract and oculoplastic procedures in 122 patients, out of which 53 were males and 69 were females, 73 were ipsilateral and 49 contralateral eyes. The postoperative follow-up period was 1 month. Results: We did not note any hemorrhage/ hematoma in any of our patients undergoing combined procedures. No post-operative ocular inflammation/ infection was noted after cataract extraction. We found that the combined procedure of ptosis under/ over correction with cataract extraction had no bearing on visual outcomes as compared to routine cataract outcomes. We noted no under or over-correction in patients undergoing ptosis correction. Conclusion: Simultaneous extra-ocular and phacoemulsification is an option for patients reluctant for multistage procedures either by choice or medical recommendations. It is also an alternative for patients with poor medical compliance and works in favour of ergonomics and economy. © 2024 Author(s), Published by Innovative Publication.
Comparison of incidence of oculocardiac reflex between hang-back and conventional rectus recession in horizontal strabismus surgery
(IP Innovative Publication Pvt. Ltd., 2020) Meghna Roy; Rajendra P. Maurya; Virendra P. Singh; Mahendra K. Singh; Sandeep Loha; Tej Bali Singh
Purpose: To compare the incidence of oculocardiac reflex(OCR) between hang-back and conventional method of rectus muscle recession in horizontal strabismus. Materials and Methods: In this prospective, randomized, double blind study, 40 consecutive patients of horizontal strabismus were evaluated. The patients were randomized into two groups based on the type of surgical recession technique employed for squint correction. Twenty patients were operated by Hang-back technique (group-1) and 20 by conventional rectus muscle recession where the muscle tendon was sutured directly to the globe (group-2). All patients underwent pre-operative evaluation which included refraction, keratometry and assessment of angle of deviation etc. ECG was monitored before surgery. During surgery heart rate (HR) was recorded as heart rate baseline (HRB), after 5 minutes of intubation (HR5), during muscle traction (HRT), Minimum heart rate during traction of muscle (HRMin), Maximum increase in heart rate (HRMax). OCR was defined as > 20% reduction in HR during muscle traction as compared to baseline HR. Results: Out of total 40 patients 17(42.50%) were having exotropia and 23 (57.50%) had esotropia. The overall incidence of OCR in conventional recession was found to be greater than that in hang-back recession. The mean baseline HR was 72.00± 7.391 beat/min in conventional recession group and 77.55± 7.494 beat/min in hang-back recession group. The mean HR reduction in conventional procedure was 56.05± 8.787 beat/min. and that in hang-back procedure 61.80 ± 9.317 beat/min., which was statistically significant (p<0.001).. This was probably attributed to the shorter duration of surgery and lesser manipulation during surgery in hang-back as compared to conventional procedure. Conclusion: OCR is a common complication encountered during manipulation of muscle during strabismus surgery. Hang-back recession is a safe and effective method of muscle recession as it offers a shorter surgical time and better exposure along with lesser incidence of OCR with similar success rates when compared to conventional muscle recession. © 2020 Innovative Publication, All rights reserved.
Comparison of spherical equivalent determined by Sanders-Retzlaff-Kraff-II (SRK-II) formula with target post-operative final refraction in patients undergoing cataract surgery
(IP Innovative Publication Pvt. Ltd., 2023) Ruchi Kabra; Krupali Raol; Hemaxi Desai; Deep Panchal; Rajendra P. Maurya; Riddhi Gajjar
Background: The most challenging subject in patient satisfaction after cataract surgery depends upon post-operative refractive outcomes. Accurately predicting post-operative refraction is necessary during the calculation of Intraocular lens (IOL) power. The Sanders-Retzlaff-Kraff (SRK) II formula is one of the few formulae being used for the calculation of IOL power. Our study is to compare the accuracy of the SRK-II formula with targeted final refraction of patients undergoing phacoemulsification. Materials and Methods: This study was performed on 102 eyes that underwent phacoemulsification. IOL power was calculated using the SRK-II formula. One and a half months after surgery, refraction was performed. Differences between actual post-operative refraction and predicted spherical equivalent was calculated and termed absolute refractive error. Paired t-test was used for comparing actual post-operative refraction and predicted spherical equivalent. Results: The mean absolute error (MAE) of the SRK-II formula was 0.44 D (diopters) overall. The percentage of eyes within ±0.5 D of the predicted spherical equivalent was 81%. Patients having post-operative refractive error within ±1.0 D for short, average, and long axial length were 88% (P value 0.21), 92% (P value 0.0009), and 91% (P value 0.18) respectively. Conclusion: We found that the SRK-II formula was accurate and reliable for predicting the post-operative refractive error in eyes with normal axial lengths as the post-operative refraction is near emmetropia and is a good method for IOL power calculation with normal axial lengths. © 2023 Author(s), Published by Innovative Publication.
Correlation of retinopathy of prematurity with oxygen saturation in preterm babies in a tertiary care center: A noble guide
(IP Innovative Publication Pvt. Ltd., 2024) Shahjadi Praveen; Syed Manazir Ali; Naheed Akhtar; Rajendra P. Maurya; Waris Abdul
Objective: To find the correlation of retinopathy of prematurity (ROP) with oxygen saturation among preterm babies in neonatal intensive care unit (NICU) of a tertiary care centre. Material and Methods: This Prospective cross-sectional study was conducted on 64 premature neonates of gestational age < 36 weeks who were on oxygen and were admitted in NICU after obtaining ethical clearance. We compare the effect of two oxygenation strategies on development of ROP in two groups. Oxygen ranged from 86-90% in one group (32 neonates) and 91-94% in another group (32 neonates). Screening of all neonates were done by one examiner. Statistical Analysis: The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 26. For categorical data, Chi-square test was used. For continuous data, Mann Witney U test were used and p-value-<0.05 was taken as significant. Results: Among 64 babies, 32 babies were on 86-90% of oxygen, 5 babies had disease and the remaining 32 babies who were on 91-94% of oxygen, 14 babies had developed disease showed a statistically significant relationship between ROP and oxygen saturation (p=0.014). Conclusions: High oxygen saturation target is one of the important risk factors leading to the development of ROP. Lower oxygen saturation reduced the prevalence as well as had no deleterious effect on general health of baby. Therefore, accurate measurement of oxygen concentration by probe and proper monitoring of SpO2 levels must be done in every NICU. © 2024 Author(s), Published by Innovative Publication.
COVID-19 and Ophthalmologists
(IP Innovative Publication Pvt. Ltd., 2020) Rajendra P. Maurya
[No abstract available]
Diabetic macular edema: An overview
(IP Innovative Publication Pvt. Ltd., 2019) Rajendra P. Maurya
[No abstract available]
Dry eye disease associated with Primary Sjogren syndrome: An update
(IP Innovative Publication Pvt. Ltd., 2021) Rajendra P. Maurya; Vibha Singh; Manisha; Ashish Gupta; Virendra P. Singh; Amit Kumar; Archana Yadav; Shivangi Singh
Primary Sjögren’s syndrome (pSS) is a chronic, multisystem autoimmune disorder, characterized by mononuclear infiltration of exocrine glands and other organs, resulting in dry eye, dry mouth and extra glandular systemic findings. Primary Sjögren syndrome is of particular interest to ophthalmologists as it constitutes an important differential diagnosis in conditions with dry eye disease. The ocular tests are of great importance for diagnosis and monitoring of primary sjogren’s syndrome. Also a better understanding of immunological mechanisms and molecular pathways have resulted in discovery of new therapeutics for local and systemic treatment. This article illustrates an update regarding pathogenesis, diagnosis, investigative procedures and treatment options for dry eye related to Sjogren’s syndrome. © 2021 Innovative Publication, All rights reserved.
Effect of diet on eye diseases and visual impairment
(IP Innovative Publication Pvt. Ltd., 2023) Rajendra P. Maurya; Sneha Gupta; Swati Gautam
[No abstract available]
Genetics and epigenetics of age related macular degeneration
(IP Innovative Publication Pvt. Ltd., 2024) Rajendra P. Maurya; Surbhi Jaiswal; Shalini Ranjan
[No abstract available]
Immunoglobulin Concentration in Tears of Contact Lens Wearers
(Wolters Kluwer Medknow Publications, 2014) Rajendra P. Maurya; Prashant Bhushan; Virendra P. Singh; Mahendra K. Singh; Prakash Kumar; Ravindra P. S. Bhatia; Usha Singh
Purpose: To evaluate changes in the concentration of tear immunoglobulins in contact lens wearers. Methods: A total of 45 cases including 23 contact lens wearers (43 eyes) and 22 age and sex matched healthy controls having no ocular pathology were studied for immunoglobulins (IgA, IgG, IgM) in their tears by single radial immunodiffusion method. Results: Most of the cases used soft (56.6%) and semi-soft gas permeable (30.4%) contact lenses. Tear IgM was detected in only 17.4% and tear IgG in 43.6% of contact lens wearers, while in controls IgG was detected in 9.1% but none of the controls had IgM. There was a significant rise in total tear IgA (13.17 ± 4.44 mg/dl) in contact lens wearer as compared to controls (8.93 ± 3.79 mg/dl). Rise of tear IgA was more in symptomatic patients (15.38 ± 5.28 mg/dl) and in those wearing hard (19.73 ± 5.43 mg/dl) and semi-soft contact lenses (13.31 ± 5.43 mg/dl). A significant increase in tear IgA was noticed in subjects wearing lenses for >3 years (15.69 ± 5.39 mg/dl). About 43.4% of lens wearers were symptomatic and 80% of their lenses showed deposits and/or haziness. All cases with IgM in tear were symptomatic. Conclusion: The relation of immunoglobulin concentration with increasing duration of wear and material of contact lens shows that tear immunoglobulin rise accrues due to mechanical stimulation, hence contact lenses should not be used for a long period and lenses of hard nature should be discouraged. The maintenance, cleaning and deproteinization of the lenses are of high importance to avoid immunostimulation.
Impact of prednisolone, dexamethasone, and fluorometholone eye drops on intraocular pressure in patients post-cataract surgery: A randomized controlled study
(IP Innovative Publication Pvt. Ltd., 2023) Sharmila Somayaji; Sangeetha R. Gore; K. Srinivasa; Abhilash; Rajendra P. Maurya
Background: After cataract surgery, topical corticosteroids are prescribed for inflammation reduction, but prolonged use may lead to side effects like steroid-induced glaucoma. These steroids can elevate intraocular pressure (IOP), and if elevated IOP isn’t promptly addressed, it may advance to glaucoma. Vigilant monitoring of IOP changes is crucial for early detection and intervention, forming the basis for this study. The objective of this study was to evaluate and compare the impact of post-cataract surgery administration of eye drops containing prednisolone, dexamethasone, and fluramethalone on Intra-Ocular pressure (IOP) in patients. Materials and Methods: Seventy-five patients were randomly allocated to three groups, each comprising thirty individuals. Participants were administered prednisolone, dexamethasone, and fluramethalone eye drops, respectively, with a tapered dosage over a 42-day period. The study involved documenting intraocular pressure (IOP) measurements both before and after the surgery. Subsequently, patients were monitored for a duration of three months. Results: Among the 75 patients, approximately 5.77% (n = 4) exhibited an increase in intraocular pressure (IOP) of ≥10 mmHg from their baseline. A moderate elevation in IOP (≥5 mmHg) was observed in about 13.44% (n = 13) of the patients. Notably, a clinically significant rise in IOP, defined as an increase of ≥10 mmHg and an overall IOP of ≥20 mmHg, occurred in 4.98% (n = 4) of the patients, all of whom were in the fluramethalone group. The mean post-operative IOP differed significantly among the three treatment groups. Conclusion: Fluromethalone possesses a heightened propensity to induce an early and substantial increase in intraocular pressure (IOP), necessitating careful and vigilant usage with continuous monitoring. © 2023 Author(s), Published by Innovative Publication.
Importance of ocular trauma score (OTS) system
(IP Innovative Publication Pvt. Ltd., 2024) Rajendra P. Maurya; Priyanka
[No abstract available]
Is amblyopia of any severity fully treatable, irrespective of a patient’s age?
(IP Innovative Publication Pvt. Ltd., 2024) Sameera Irfan; Nausherwan Aadil; Rajendra P. Maurya; Mohammad Saqib
Primary Objectives: 1: To find out the level of visual improvement and the time it takes in amblyopia of any severity. 2: To find out whether the level of visual improvement is influenced by a patient’s age at presentation. Secondary Objectives: 1: To note whether the level of visual recovery is influenced by previous amblyopia therapy. 2: To note any regression of visual acuity with time after initial improvement by therapy. 3: To note complications of full-time occlusion therapy, especially occlusion amblyopia. Materials and Methods: In a prospective interventional study, 1701 consecutive cases with poor vision were included irrespective of a patient’s age. After wearing refractive correction for 8-12 weeks and no further improvement in the BCVA, amblyopia therapy was started comprising of full-time patching of the good eye along with active use of the amblyopic eye by reading and writing at least 6 hours daily. Regular two weekly follow-ups were conducted. The endpoint of therapy was achieving a BCVA equal to that of the good eye. A regular post-patching follow-up was conducted for 1-3 years. Statistical analysis comparing the visual acuity at the start and the end of therapy was performed by a paired t-test for each group. Results: There were 896 male and 805 female cases. 1383 cases (81.3%) had previously failed amblyopia therapy. 49 cases (2.9%) dropped out of the study due to poor compliance with therapy or an incomplete follow-up. For a simplified analysis of results, the 1701 cases were divided into three age groups: Group A: age 4-7 years (473 cases), Group B: age 8-12 years (618 cases) and Group C: age 13-46 years (610 cases). The overall success in Group A and B cases was 98% and 96.9% in Group C cases. Conclusion: Full visual recovery is possible in amblyopia of any severity and age. The age of a patient at presentation should not preclude therapy. © 2024 Author(s).
Navigating competency-based medical education in ophthalmology: Addressing challenges and charting future trajectories
(IP Innovative Publication Pvt. Ltd., 2024) Rahul Singh; Disha Chaudhary; Brijesh Kr Kushwaha; Rajendra P. Maurya
Based Medical Education (CBME) has emerged as a transformative approach to medical training, emphasizing skills acquisition and holistic competence over traditional knowledge retention. Ophthalmology, as a specialized field, presents unique challenges and opportunities within this framework. This article critically examines the implementation of CBME in ophthalmology, highlighting challenges faced and proposing strategies for enhancement. By addressing stakeholder perspectives and strategic interventions, this viewpoint aims to foster a comprehensive understanding of CBME’s implications for ophthalmological education. © 2024 Author(s), Published by Innovative Publication.
New advances in treatment of dry eye disease
(IP Innovative Publication Pvt. Ltd., 2021) Rajendra P. Maurya; Shivangi Singh
[No abstract available]
Novel incision to debulk eyelids in a case of Orbital Periorbital Plexiform Neurofibroma (OPPN): A case report
(IP Innovative Publication Pvt. Ltd., 2023) Umesh Kumar; Sudipta Bera; Shikha Jaiswal; K Cheruvu Natraj Navya; Vivek Vijay Kumar; Rajendra P. Maurya
Background: Plexiform neurofibroma with neurofibromatosis 1 is a autosomal dominant condition and a relatively rare condition. It is also termed as Von Recklinghausen disease. PN involving the structures like eyelid, orbit, periorbital and facial structures are labelled as orbital-periorbital PN(OPPN). These are slowly progressing lesions and are present since birth but increase in size during childhood and are locally infiltrating in nature. Aim: To describe a lid incision to simultaneously debulk both upper and lower eyelid, preserving the vascularity in a case of Orbital Periorbital Plexiform Neurofibroma (OPPN). Case Presentation: We report a case of 22 year male who presented with a disfiguring swelling of right side of face since childhood. After thorough clinical and radiological evaluation it was diagnosed to be a OPPN. Staged debulking was planned and after stage 1 debulking, tissue was sent for HPE which revealed overgrowth of peripheral nerve components and connective tissue dermis showing infiltrating tumour composed of oval to spindle cells with pleomorphic nuclei and moderate cytoplasm. Staged debulking with lid reduction surgery was performed. Discussion: Neurofibroma is a rare entity with plexiform neurofibroma occurring in 5-15% of patients. OPPN infiltrates locally without respecting the anatomical planes but follows the trigeminal nerve distribution usually. Indications for debulking procedure are usually the disfigurement and optimal timing is also not certain because the extent and rate of growth cannot be predicted. Conclusion: The facial appearance and outcome in patients with OPPN can be significantly improved through lid reduction surgery. © 2023 Author(s), Published by Innovative Publication.