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The demand for treating diseases using yoga therapy, a Complementary and Alternative Medicine (CAM) treatment, has increased globally. An increase in the research in this yoga area from fewer than 10 research publications per year in the 1990s to at least 20 per year after 2010 is evidence of this change in treatment needs over time. The beneficial effect of yoga therapy has been limited to practice in acute care despite its remarkable success in this domain. This is due to many factors that impact the therapy's effectiveness, irrespective of disease indications. However, the prime challenges for its effectiveness lie with the reliability of the yoga trial outcome and reporting. There is a great need to reevaluate the yoga trials' reporting for the reliability of their outcome. This study attempts to address the issue by studying challenges for presbyopia with yoga interventions. Among many indications, progressive vision loss (presbyopia), which occurs due to refractive errors in the ocular region, has scope to be treated effectively with yoga therapies. However, trials for yoga interventions for treating refractive errors have not been studied well. This study was conducted to understand the challenges in yoga therapy trials and its potential to treat presbyopia. The CLARIFY guidelines were used to understand the challenges and factors that impact effective treatment in the current research landscape. We found that trials conducted are not in compliance with the reporting guidelines. Adaptation of CLARIFY guidelines is essential to produce reliable evidence to prescribe yoga therapies to treat refractive errors.

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PURPOSE: We report the rare occurrence of unilateral acute hypertensive uveitis in the acute phase of systemic leptospirosis. METHODS: Observational case report and review of literature. RESULTS: A young male mason from coastal Karnataka in south India, presenting with acute febrile illness, was diagnosed to have systemic leptospirosis. He also had features of sudden raised intraocular pressure with anterior uveitis in one eye, which subsided with medical management. CONCLUSION: Leptospirosis should be considered as a differential in the diagnosis of acute hypertensive uveitis.

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Purpose: To compare the stereopsis in patients with various grades of cataract and bilateral pseudophakia. Methods: A cross-sectional observational study was conducted at a tertiary care center in South India from December 2016 to September 2018, wherein the stereoacuity of patients having bilateral senile cataract or bilateral pseudophakia, was measured using the Titmus Fly chart. Those with any form of squint, glaucoma or retinal pathology were excluded. The patients were divided into three groups based on the severity of cataract, determined by the Lens Opacification Classification System (LOCS)-III. Group 4 included those with bilateral pseudophakia. Statistical analysis was performed using one-way ANOVA test with post hoc analysis using the Bonferroni test, to study the difference of stereoacuity between the groups. Results: A total of 200 patients were evaluated. The mean stereoacuity was 65.2 ± 18.2, 114.8 ± 83.42, 402.4 ± 223.7 and 107.2 ± 71.68 arc seconds in groups 1, 2, 3 and 4, respectively (P < 0.001). The mean best corrected visual acuity (BCVA) in LogMAR units was 0.19 ± 0.15, 0.37 ± 0.24, 0.82 ± 0.26 and 0.14 ± 0.13 in groups 1, 2, 3 and 4, respectively (P = 0.01). On comparison between four groups, there was a generalised decrease in BCVA and stereoacuity with increasing grades of cataract except for group 4 which included the bilateral pseudophakics. On post hoc analysis to analyse intergroup variation a statistically significant difference in stereo acuity was noticed when group 3 was compared to other groups. Conclusion: Stereoacuity decreases with increasing grades of cataract. Better stereoacuity is seen in patients with bilateral pseudophakia when compared with high grades of cataract.

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Purpose: To compare the posterior capsular opacification (PCO) after implantation of three types of hydrophobic square edge intraocular lenses (IOLs). Methods: A single-center, hospital-based, cross-sectional, observational study was conducted wherein patients with senile cataract who had undergone phacoemulsification by a single surgeon, with the implantation of three different types of square edge, hydrophobic IOLs [Group 1: enVista, Bausch and Lomb; Group 2: Tecnis 1 ZCBOO, AMO and Group 3: Acrysof IQ SN60WF, Alcon], and followed up for 12 months were included. The PCO was graded clinically and scored using the EPCO 2000 software. Results: 90 eyes of 90 patients were included. There was no significant difference in the PCO with respect to age, gender, or associated presence of systemic disease. The median PCO score was 0.035, 0.045 and 0.085 in groups 1, 2 and 3, respectively. The PCO grade and score differences between the groups were statistically significant with P < 0.001. Conclusion: The hydrophobic nature and posterior square edge design in the IOLs probably contributed to the minimal visually-significant PCO in all the groups, in our study. However, PCO scores were lesser in the square edge IOLs having a continuous 360 degrees posterior enhanced barrier, than those without this feature.

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We present a novel and fully automated fundus image processing technique for glaucoma prescreening based on the rim-to-disc ratio (RDR). The technique accurately segments the optic disc and optic cup and then computes the RDR based on which it is possible to differentiate a normal fundus from a glaucomatous one. The technique performs a further categorization into normal, moderate, or severely glaucomatous classes following the disc-damage-likelihood scale (DDLS). To the best of our knowledge, this is the first engineering attempt at using RDR and DDLS to perform glaucoma severity assessment. The segmentation of the optic disc and cup is based on the active disc, whose parameters are optimized to maximize the local contrast. The optimization is performed efficiently by means of a multiscale representation, accelerated gradient-descent, and Green's theorem. Validations are performed on several publicly available databases as well as data provided by manufacturers of some commercially available fundus imaging devices. The segmentation and classification performance is assessed against expert clinician annotations in terms of sensitivity, specificity, accuracy, Jaccard, and Dice similarity indices. The results show that RDR based automated glaucoma assessment is about 8% to 10% more accurate than a cup-to-disc ratio (CDR) based system. An ablation study carried out considering the ground-truth expert outlines alone for classification showed that RDR is superior to CDR by 5.28% in a two-stage classification and about 3.21% in a three-stage severity grading.

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PURPOSE: The purpose of this study is to compare the contrast sensitivity function (CSF) between eyes of age-matched individuals with aspheric intraocular lens (IOL) and emmetropia. METHODS: A prospective hospital-based case-control study in South India was conducted to study the CSF in the eyes of patients between the ages of 50-60 years. The CSF was compared between those with emmetropia and those implanted with an indigenous aspheric IOL. Twenty-five consecutive patients were recruited in both groups. The independent sample t-test was used for analysis. RESULTS: The mean age was 53.08 ± 1.96 years and 57.68 ± 2.85 years in normal emmetropes and emmetropic pseudophakic with aspheric IOL, respectively. The mean CSF showed a statistically significant difference (P < 0.000) between the normal emmetropic eyes and pseudophakic eyes with the values being 1.91 and 1.572, respectively. CONCLUSION: The CSF was significantly better in the eyes of age-matched normal emmetropes when compared to those with an aspheric IOL implanted.

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Introduction: Psoriasis is a chronic immune-mediated disorder with predominantly dermatological manifestations and varying prevalence in different parts of the world. Data on the ocular features of this disease are limited. Hence, we aimed to estimate the burden of ocular disease in psoriatic patients in the Indian population. Materials and methods: An interdisciplinary cross-sectional hospital-based observational study was conducted in South India, wherein an ophthalmological evaluation was performed for the patients with Psoriasis. The ocular features were recorded and compared with the severity of psoriasis using the Psoriasis Area Severity Index (PASI) score. Results: Ocular morbidity was observed in 80% of the patients with psoriasis which increased with increasing duration (p = 0.004) and increasing PASI score (p < 0.001). Blepharitis and dry eye disease were common in our patients with psoriasis. Conclusion: It is important to screen patients with psoriasis for ocular comorbidities so as to prevent sight-threatening complications.

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Purpose: The purpose was to study the retinopathy status in diabetic patients with a risk of diabetic foot (DF) syndrome visiting a tertiary care hospital in South India. Methods: In this cross sectional study all patients with diabetes mellitus (DM) with a risk of DF syndrome, visiting a tertiary care hospital during the study period, underwent an ophthalmological evaluation for documentation of their retinopathy status. Results: One hundred and eighty-two patients diagnosed to have a risk profile for DF syndrome were included in the study. Their mean age was 59.28 years and 75.27% were males. The mean duration of Type 1 and Type 2 variants of DM was 14.9 years and 10.9 years, respectively. Of the 182 patients, 67.58% had retinopathy changes. Proliferative diabetic retinopathy (DR) constituted 17.88% of the total patients with retinopathy. An increased presence of retinopathy in patients with an increased risk grade of DF was found significant by the Chi-square test (P < 0.001). Conclusion: Our study found an increased presence of DR in a South Indian cohort with DF syndrome. The severity of retinopathy was greater in patients with higher grades of risk for DF. The establishment of an association between DR and DF syndrome will help in developing an integrated management strategy for these two debilitating consequences of diabetes.

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We present a rare case of corneal ulcer caused by a species of a coelomycetes fungus, Chaetomium strumarium. This fungal genus is a rare causative agent of keratomycosis, with only a handful of cases reported. The clinical presentation, investigative techniques, and preliminary management of our patient are reported. The cases reported in global literature are also summarized in a tabular form in the discussion.

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