Tribal Odisha Eye Disease Study # 11 - Particularly vulnerable tribal group eye health program. Program protocol and validation

Purpose:To describe and validate the eye health program protocol of Dongria tribal community, a particularly vulnerable tribal group (PVTG) in Rayagada district, Odisha, India.Methods:The program would consist of three segments. At people’s residences, trained community health workers (CHWs) will measure the vision and collect demographic data. In addition, vision technicians (VTs) will refract using a hand-held device and prescribe spectacles to people who improve to >6/12, N8. Others would be referred to the vision center (VC). At VC, the VT will perform a slit-lamp examination and re-refract. They would refer people with vision ≤6/12 to the secondary center (SC). At SC, referred people will receive a comprehensive eye examination and treatment. The ophthalmologist will assign the cause of blindness and visual impairment for people with visual acuity <6/12. The entire process was rehearsed in a pilot study.Results:The target population is approximately 10,000 people residing in 101 hutments on the hills of Rayagada district. The pilot study included 126 people. The mean age was 44 ± 18 years; 70% of the people were illiterate, and in this cohort, 97.6% (n = 123) had never worn spectacles. In the pilot study, 41% of the people had cataract, and 12% had pterygium. The agreements between optometrist versus VTs and between optometrist versus CHWs were good (k = ~0.8–1.0) in all eye conditions except for strabismus (k = ~0.56–0.65)Conclusion:The pilot study confirms the program modality, and when completed, it would help in the planning and resource allocation of Odisha PVTG eye care.     

Stromal and endothelial herpes simplex virus keratitis reactivation in the convalescent period of COVID-19 – A case report

A 73-year-old lady presented with a white spot and redness in the left eye for 1 month and had been treated elsewhere as a case of fungal keratitis. She had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection 2 months before. Her past ocular history and examination gave a probable diagnosis of herpetic stromal and endothelial keratitis. She responded to oral acyclovir and topical steroid, leading to resolution of stromal edema and inflammation. Anterior chamber fluid polymerase chain reaction (PCR) confirmed pathogen herpes simplex virus (HSV)-1. HSV ocular reactivation after coronavirus disease 2019 (COVID-19) has been reported currently. The present report will add knowledge about this potential opportunistic ophthalmic infection during the recovery phase of COVID-19 disease.     

Substituting Resistance Spot Welding with Flexible Laser Spot Welding to Join Ultra-Thin Foil of Inconel 718 to Thick 410 Steel

This paper investigated various aspects of replacing existing micro-resistance spot welding (micro-RSW) with micro-laser spot welding for joining Inconel 718 thin foils to thick 410 steel stack-up to allow faster, non-contact joining together with flexibility in spot positioning and removal of tip dressing required for RSW electrodes. The joint quality was evaluated based on the mechanical strength, microstructural characteristics and joint strength at elevated temperature as these joints are often used for high-temperature applications. Experimental investigations were performed using micro-RSW and micro-laser spot welding to obtain the 90° peel and lap shear specimens, each comprising four spots. The obtained strength from laser joints was significantly higher than that of micro-RSW joints due to larger weld nugget formation and interface width. The process map for obtaining good quality welds was also identified, and about a 17% reduction in joint strength was obtained when welded specimens were subjected to elevated temperature (i.e., 500 °C) in comparison with room temperature. This reduction was compensated for using the flexibility of laser welding to add two extra spots. The overall performance of the micro-laser spot welds was found to be better than the micro-RSW considering joint strength, flexibility in placing the spots and time to produce the welds.