L V Prasad Eye Institute

To describe a novel optical coherence tomography finding called "scolex sign" in cases of central serous chorioretinopathy. This retrospective multicenter study included patients with central serous chorioretinopathy with serous pigment epithelial detachments (PEDs) greater than 100 µ m, with or without subretinal fluid. Eyes showing a distinct hyperreflective focus on the PED wall (scolex sign) were analyzed. An equal number of age-matched controls with PEDs but without the scolex sign were included. Multimodal imaging data were reviewed. A subgroup analysis based on subretinal fluid status was also performed. Of 291 eyes with large serous PEDs, 52 eyes exhibited the "scolex sign" and were compared with 52 age-matched controls. Baseline characteristics including sex, systemic comorbidities, best-recorded visual acuity and optical coherence tomography parameters were similar in both the groups. However, eyes with the "scolex" sign exhibited a greater number of central PEDs and shorter distance from the foveal center. On follow-up, eyes with the "scolex" sign showed a higher rate of PED flattening and subretinal fluid resolution trended to be higher compared with controls. The "scolex" sign represents a novel, benign optical coherence tomography feature seen in a subset of central serous chorioretinopathy cases. While not associated with poorer outcomes or adverse sequelae, it may reflect ongoing reparative changes, indicating a resolving stage of the disease.

Traditional medical systems across the world have long employed plant-based remedies for the management of eye disorders. Ethnomedicinal knowledge plays a vital role in primary eye care. The present study compiles and analyses ethnomedicinal plants traditionally used for the treatment of various eye problems through literature survey. A total of 30 common plant species belonging to diverse botanical families were documented in this communication. It was noticed that leaves, roots, fruits, flowers and bark were the most frequently utilized plant parts while decoctions, extracts, distillates, pastes and eye washes constituted the major preparation methods. Several remedies were applied topically as eye drops or washes whereas others were consumed orally or used as dietary supplements. The continued use of these remedies highlights their perceived therapeutic efficacy and cultural importance. However, scientific validation, standardization and safety assessment remain limited for many formulations. Therefore, the paper highlights the need for pharmacological and clinical investigations to validate traditional claims and to support the development of safe and plant-based ophthalmic therapeutics.

Infectious keratitis remains a leading cause of corneal blindness and visual impairment worldwide, with bacterial, fungal, amoebic and viral pathogens presenting major diagnostic and therapeutic challenges. Early and precise pathogen identification is essential to initiate early treatment and prevent irreversible ocular damage. Direct visualisation of pathogens by microscopy of corneal scrapings has been one of the most rewarding and time-tested methods; however, ocular microbiology laboratories seem to be losing the expertise for the same. Culture methods also seem to be losing favour for their long turnaround time and low sensitivity. These have paved the way for newer, rapid and sensitive molecular techniques to make a foray into the realm of diagnosis of non-viral keratitis. This review critically evaluates recent advances in molecular diagnostics for infectious keratitis, focusing on DNA/RNA-based sequencing, real-time PCR (qPCR) and mass spectrometry (MS) and examines their clinical relevance, limitations and potential for point-of-care application.An extensive literature analysis was conducted, integrating findings from peer-reviewed studies published between 2000 and 2025. Emerging diagnostic platforms were compared with conventional microbiological methods in terms of diagnostic accuracy, turnaround time and clinical applicability across paediatric and adult cohorts. Traditional culture-based approaches exhibit limited sensitivity (30%-60%) and slow pathogen detection. In contrast, multiplex and quantitative PCR enable rapid, sensitive and specific pathogen identification, including in culture-negative cases. Next-generation sequencing offers broad-spectrum, culture-independent profiling of bacteria, fungi and protozoa, enhancing diagnostic yield and understanding of pathogen diversity. MS has transformed microbial and host proteomic/metabolomic analyses, identifying candidate biomarkers for disease severity and prognosis. Recent innovations such as portable qPCR devices, clustered regularly interspaced short palindromic repeats-based diagnostics and artificial intelligence-assisted data interpretation extend molecular testing to near-patient settings. The integration of these technologies into routine clinical workflows promises earlier intervention, personalised therapy and improved visual outcomes, particularly in resource-limited environments.

India accounts for a substantial share of the global burden of vision impairment, with moderate to severe impairment especially common among adults over 50, women, and people without formal education. This study aims to identify modifiable barriers and enablers to accessing eye care services in India and to map these factors to the Theoretical Domains Framework (TDF), providing a theory-based understanding of the behaviours influencing service uptake and guiding effective behaviour change interventions. A systematic review of MEDLINE Complete, CINAHL Complete, PsycINFO, and EMBASE identified studies reporting determinants of eye care-seeking in India. English-language studies published up to January 2025 were included. Data were analysed using a four-step approach: (1) data extraction, (2) deductive mapping to TDF domains, (3) inductive thematic synthesis and (4) identification of key domains based on frequency and elaboration. A total of 56 primary studies were included in the analysis. The six most important TDF domains were: Environmental Context and Resources, Social Influences, Beliefs about Capabilities, Knowledge, Emotion and Beliefs about Consequences. Commonly reported barriers included a 'lack of understanding about eye conditions', 'financial constraints', 'no one to accompany', 'family commitments', 'limited access to services' and 'able to manage with existing vision'. Enablers included 'free eye care services', 'positive experiences of others and 'perceived need for vision care. The most salient TDF domains were mapped onto the capability, opportunity, and motivation model of behaviour (COM-B) within the behaviour change wheel (BCW) to guide the design of interventions. This review identified six TDF domains influencing eye-care service uptake in India. By mapping these domains to appropriate intervention functions from the behaviour change wheel, the study offered a structured, evidence-based approach to designing behavioural interventions aimed at increasing the utilisation of eye care services.

To report unique clinical features and management challenges in patients with co-existing Thyroid Eye Disease (TED) and Floppy Eyelid Syndrome (FES). Retrospective, multicentric, interventional case series of 9 patients presenting as TED with FES over a period of eight years. Seventeen eyes with co-existing TED and FES were analysed. The average age at presentation was 51.5years. There were five males and four females in the cohort. Hypothyroidism and hyperthyroidism were noted in four cases each, while a single patient was euthyroid at presentation. The average exophthalmometry value was 25.5mm (range, 22-30mm). All but one had bilateral presentation. Of the 17 eyes, 13 (76%) had episodes of spontaneous globe luxation. Eleven eyes (65%) had congestive signs or surface exposure, which mimicked clinically active TED. Lash ptosis was observed in six (35%) eyes. All (100%) eyes had significant lower eyelid retraction (LER) with inferior scleral show. Upper eyelid retraction was absent in 14 (82%) eyes. Of the six cases where orbital imaging was available, fat-predominant disease was seen in nine orbits. TED and FES can rarely co-exist. The lax or ptotic upper eyelid tends to mask upper eyelid retraction, with LER being a more obvious sign. Spontaneous globe luxation may be more common in this cohort, warranting early orbital decompression. Congestive signs and corneal exposure may mimic clinically active TED, potentially leading to corticosteroid misuse.

Persistent optic disc bleeding during pars plana vitrectomy (PPV) is difficult to manage. This study aims to explore the use of fibrin glue as a novel agent to achieve hemostasis in such eyes. Interventional case series of patients with vitreous hemorrhage (VH) or tractional retinal detachment (TRD) due to proliferative diabetic retinopathy, retinal vein occlusion or retinal vasculitis, in whom fibrin glue was used intraoperatively for hemostasis. All the patients were followed up for 1 month. 14 eyes of 14 patients were included, of which 12 (85.7%) were male with mean age of 52 years. Surgery was performed in 10 eyes (71.4%) for VH and 4 eyes (28.6%) for TRD. The mean best corrected visual acuity (BCVA) improved from 1.33±0.53 Logarithm of the Minimum Angle of Resolution (logMAR) (20/428), to 0.42± 0.35 logMAR (20/53) 1 month after surgery (P = 0.002), 0.43± 0.32 logMAR (20/54) 3 months after surgery (p = 0.003) and 0.36±0.34 logMAR (20/46) at a mean of 7 months (p = 0.002) after the surgery. Post operative vitreous cavity hemorrhage occurred in 1 eye (7.1%), which did not require a repeat surgery. This report demonstrates the efficacy of fibrin glue used during vitrectomy in controlling persistent optic disc hemorrhage in a cohort of diverse etiologies. Persistent intraoperative optic disc bleeding is difficult to manage with adverse outcomes. Fibrin glue is a short acting bioadhesive, which has shown favorable outcomes when used in rhegmatogenous retinal detachment and macular hole surgeries. Our prospective interventional study shows that the use of fibrin glue is a valuable technique to manage optic disc bleeders, allowing for better and faster visual recovery, while reducing the incidences of rebleeding and reoperations. Of the 14 eyes included in our study, post-operative vitreous cavity hemorrhage occurred in just one case, which resolved spontaneously, and did not need any reoperation.