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Background We report a case of spontaneous resolution of a traumatic cataract in a patient with an open-globe ocular injury. This case highlights the importance of conservative management in these types of cases, as excellent visual outcome is possible without invasive surgical intervention. Case presentation A 13-year-old boy presented with a corneal laceration in the left eye caused by a neuter pen. He underwent emergency repair of the corneal laceration under general anesthesia, and at 3 days post-op, a dense posterior cortical cataract was observed. Based on the patient’s age and normal visual development, in addition to preserving accommodative potential, the patient received conservative management and follow-up. Interestingly, the cataract spontaneously resolved over the following 9 months and the corrected distance visual acuity in the injured eye was restored from finger counting at 50 cm, to 20/25 + 3. Conclusions To optimize treatment in pediatric traumatic cataract, several critical factors such as age, visual development and the preservation of accommodative potential, need to be comprehensively considered. Conservative management with lens preservation is important to consider in young, traumatic cataract patients where invasive surgical intervention may not be required.

Publishing manuscripts is the only way by which scientists communicate with each other. In recent times, there is an increasing desire to publish manuscripts from the developing world for a variety of reasons. Though, performing a research study is challenging in itself, writing it for publication is the final frontier that can be daunting, especially for the novice. Work that remains unpublished in one form or the other is essentially incomplete or undone. Hence, it is critically important for one to publish one′s findings in a reputed journal. The purpose of this paper is to alleviate the mystique involved in manuscript writing and provide a blueprint where the subheadings given under each of the sections of introduction, methods, results and discussion can be expanded as per the particular study and the manuscript can be constructed in a stepwise manner. We hope that by following this approach, potential researchers and practicing ophthalmologists will develop the skill and aptitude for medical writing, and that the developing world shall do justice to its tremendous intellectual capital by making meaningful contributions to global scientific literature.

Intravitreal application of Ozurdex ® (Allergan, Inc., Irvine, CA, USA) which is a biodegradable, sustained-release dexamethasone implant has been reported to be effective in the treatment of macular edema. Migration of such implant into the anterior chamber has been recently described in cases without perfect zonular or the posterior capsular integrity. Herein, we report the first case with anterior migration of Ozurdex ® implant that mislocated just behind the intraocular lens (IOL) in an intact capsular bag. It is thought that such implant migrated anteriorly towards into the posterior chamber through weak zonules as the present case had a medical history of uneventful phacoemulsification surgery with the implantation of posterior chamber IOL. However, the migrated implant was well tolerated since there was no sign of the corneal complication, rise in intraocular pressure, and anterior chamber reaction. Close follow-up was scheduled to find out any signs of anterior segment pathology. Meanwhile dexamethasone implant completely degraded at the 4 th month of postoperative follow-up.

Objective: The objective was to provide evidence-based care for patients with traumatic cataracts, we assessed whether a posterior capsulotomy and anterior vitrectomy, as part of the primary surgical procedure, could be a positive predictor of final visual outcome. Materials and Methods: This is a prospective randomized control trial. Patients presenting at our hospital between January 2010 and December 2012 having ocular trauma and traumatic cataracts were enrolled, according to the inclusion criteria. We enrolled two groups: Those with and without primary posterior capsulotomy and vitrectomy. Information regarding demographic and ocular trauma were collected using the World Eye Trauma Registry form at the first visit and follow-up, and specific information was collected for both the group who underwent posterior capsulectomies and vitrectomies as a part of the primary procedure, and the control group. Data were analyzed to evaluate the predictive value of primary posterior capsulectomy and anterior vitrectomy. Results: We enrolled 120 cases, 60 in each group, comprising 31 females and 89 males. When all other variables were controlled for, the visual outcome (best corrected visual acuity) differed significantly (P < 0.001) between the groups. Conclusion: Performance of posterior capsulectomy and anterior vitrectomy as part of the primary procedure improves the final visual outcome.

The prevalence and nature of corneal astigmatism among patients with cataract has not been well-documented in the resident African population. This retrospective study was undertaken to investigate preexisting corneal astigmatism in adult patients with cataract. We analyzed keratometric readings acquired by manual Javal-Schiotz keratometry before surgery between January 1, 2011 and December 31, 2011. There were 3,169 patients (3286 eyes) aged between 16 and 110 years involved with a Male to female ratio of 1.4:1. Mean keratometry in diopters was K1 = 43.99 and K2 = 43.80. Mean corneal astigmatism was 1.16 diopter and a majority (45.92%) of eyes had astigmatism between 1.00 and 1.99 diopters. Two-thirds of the eyes (66.9%) in this study had preoperative corneal astigmatism equal to or above 1.00 diopter. Findings will help local cataract surgeons to estimate the potential demand for toric intraocular lenses.

We report a case of a 2-month-old baby with bilateral nonsyndromic partial cryptophthalmos presenting with upper eyelid incomplete development and fusion to the cornea with resultant inability to close the eyes. He was managed successfully with bilateral upper lid reconstruction with composite graft using maternal skin and oral mucous membrane, amniotic membrane, and donor scleral graft. After this one stage surgery, lids were well-formed, and the patient was able to close both eyes, thus achieving good anatomical, functional, and cosmetic outcome.

Purpose To investigate the performance of 10 MHz ultrasonography in detecting posterior lens capsule defects before traumatic cataract surgery. Methods This retrospective analysis includes patients with traumatic cataracts who underwent cataract surgery. Preoperative 10 MHz ultrasonography was performed to evaluate whether the posterior lens capsule was defective or intact, and the results were compared to the intraoperative findings. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and kappa were calculated. Results The study included 140 eyes of 140 patients. There were 68 eyes with closed-globe injuries and 72 eyes with open-globe injuries. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and kappa of 10 MHz ultrasonography was 86.76%, 90.28%, 89.39%, 87.84%, 88.57% and 0.771, respectively. The accuracy was 86.11% and 91.18% in open-globe and closed-globe injury groups, respectively. Conclusion The accuracy of 10 MHz ultrasonography in evaluating the posterior lens capsule in traumatic cataracts is high. Preoperative 10 MHz ultrasonography would help to make an appropriate surgical plan.

Purpose: Goldmann applanation tonometer (GAT) is the current Gold standard tonometer. However, its calibration error is common and can go unnoticed in clinics. Its company repair has limitations. The purpose of this report is to describe a self-taught technique of rectifying calibration error of GAT. Materials and Methods: Twenty-nine slit-lamp-mounted Haag-Streit Goldmann tonometers (Model AT 900 C/M; Haag-Streit, Switzerland) were included in this cross-sectional interventional pilot study. The technique of rectification of calibration error of the tonometer involved cleaning and lubrication of the instrument followed by alignment of weights when lubrication alone didn′t suffice. We followed the South East Asia Glaucoma Interest Group′s definition of calibration error tolerance (acceptable GAT calibration error within ±2, ±3 and ±4 mm Hg at the 0, 20 and 60-mm Hg testing levels, respectively). Results: Twelve out of 29 (41.3%) GATs were out of calibration. The range of positive and negative calibration error at the clinically most important 20-mm Hg testing level was 0.5 to 20 mm Hg and -0.5 to -18 mm Hg, respectively. Cleaning and lubrication alone sufficed to rectify calibration error of 11 (91.6%) faulty instruments. Only one (8.3%) faulty GAT required alignment of the counter-weight. Conclusions: Rectification of calibration error of GAT is possible in-house. Cleaning and lubrication of GAT can be carried out even by eye care professionals and may suffice to rectify calibration error in the majority of faulty instruments. Such an exercise may drastically reduce the downtime of the Gold standard tonometer.

Lightning-induced ocular injuries are rare but potentially severe sequelae. This case report describes a 35-year-old male patient who suffered a lightning strike injury 20 years ago, resulting in traumatic cataract and optic nerve damage in his left eye. When the patient presented for consultation, he exhibited a significant decrease in left eye visual acuity. Detailed ophthalmic examinations and auxiliary tests confirmed the presence of cataract and optic nerve impairment. The patient underwent left eye phacoemulsification cataract surgery and intraocular lens implantation, leading to improved visual acuity and posterior segment conditions. However, this case highlights the complexity and therapeutic challenges of lightning-induced cataract with concomitant optic nerve damage. The discussion addresses the mechanisms of optic nerve damage following lightning strike and underscores the importance of early intervention. This report emphasizes the significance of assessing optic nerve function in lightning strike patients and provides new perspectives for related research and treatment.

Background: Traumatic cataracts present in multiple and different forms. Based on the nature of injury, it necessitates a customized approach for individual case. Capsulorhexis and in the bag intraocular lens (IOL) placement are vital for long term centration of pediatric IOLs. Paediatric lenses having elastic capsule provide more challenges to perform optimum rhexis and the surgery becomes further complicated, when it is subluxated or fibrosed. Here is a pediatric case with such challenges managed using capsular tension ring (CTR) and capsular tension segment (CTS). Purpose: To demonstrate the making of optimum rhexis in a fibrosed capsule in subluxated lens and placing the IOL along with fixation of bag using CTR and CTS. Synopsis: A 13-year-old boy sustained an injury in the right eye from an air pistol, underwent lid tear repair in a local hospital, and presented to us one month post trauma with visual acuity of 6/60 in the right eye and 6/6 in the left eye. On examination, there was more than 180° temporal zonular dialysis with fibrosis of the anterior capsule. In this situation, creating an intact capsulorhexis was a challenge which was solved using micro-scissors and micro-vitreo-retinal forceps, in addition to routine instruments. After removing the lens material, CTS was placed initially in the bag to stabilize it while introducing CTR. The CTS was then fixated to the sclera. Foldable IOL was placed in the bag. Technique and tips to make intact rhexis and easy passage of suture are demonstrated. Highlights: This video shows tips and different methods adopted in each step of the surgery for successful placement of IOL in bag along with fixation of bag using CTR and CTS in a case of traumatic subluxated cataract with shrunken anterior lens capsule. Video link: https://youtu.be/Vwp1qUh1Mrc Key words: Capsular Tension Ring, Capsular Tension Segment, Paediatric cataract, Subluxated lens, Traumatic cataract