key: cord-0845143-fgt8f5yt
authors: Gosalia, Hirika; Kene, Rakshita D; Verghese, Shishir; Narendran, Kalpana
title: Do it yourself fixation target: Magnifix
date: 2021-12-03
journal: Indian J Ophthalmol
DOI: 10.4103/ijo.ijo_1688_21
sha: 464eace3b4dd50d91c9555a0991017512febf3cc
doc_id: 845143
cord_uid: fgt8f5yt

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: (a) Coin magnets and fridge magnets used as fixation target; (b) easy mobility of the DIY Magnifix over the safe slit-lamp shield due to the attractive force between the two coin magnets b a 

Dear Editor, Eye fixation during slit-lamp examination is an important prerequisite for a careful and proper ocular exam. Difficult target fixation of the patient's eye during slit-lamp examination is a common problem faced by ophthalmologists. Attempts are made by an examiner by asking the patients to fixate on a certain target to obtain a stable fixation; however, they are often unsatisfactory due to inability of few patients to comply with instructions, lack of a proper target, or obstruction due to movement of the optical portion of the slit lamp. [1] Patients tend to have a still gaze when they fixate on a simple visual target. [2] Previous studies have reported the best fixation stability with combination of bull's eye and crosshair. [3] The COVID-19 pandemic has led to the introduction of a slit-lamp shield, which prevents aerosol transmission between the doctor and patient. [4] The presence of a faded shield can lead to further confusion during target fixation. Using the slit-lamp shield as a base, we attached two coin magnets (10 mm × 1 mm) on either side of the shield to make a freely movable fixation target named magnifix [ Fig. 1a and b]. The coin magnet facing the patient is stuck with a red reflector that helps in an easier fixation location. The magnetic force makes the movement on the shield easy with good fixation location and ocular stability in the clinician's desired direction. Attractive magnets can be used for pediatric patients for easy compliance and fixation.

Magnifix is a cost effective, universal, do it yourself solution to the basic problem of target fixation during slit-lamp examination. It is especially indicated when accurate, prolonged, and yet variable fixation is desired. We have found that it is of particular value for corneal foreign body removal, pediatric patients, uncooperative patients, and hard of hearing patients [ Fig. 2a -d].

Mr. Vipul Pravin Gosalia, Mrs. Nayana Vipul Gosalia, Mr Manank Vipul Gosalia.

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Nil.

There are no conflicts of interest. vaccine uptake in patients with ocular surface diseases: A survey Dear Editor, As we write this letter, India is recovering from a devastating second wave that has claimed countless lives across the country and preparing for the imminent possibility of future waves. [1] The various vaccines developed through rigorous research and clinical trials around the world have effectively shown to reduce both the risk of hospitalizations and the severity of the disease due to the SARS-CoV-2 novel coronavirus virus. [2] India is known as the vaccine capital of the world and had assumed a leadership role in dispatching more than 664 lakh doses to 95 countries. [3] With just 9.4% of the population receiving both the doses of the vaccine and 23% partly vaccinated against COVID-19, India is in a tight spot with a large number of vulnerable individuals potentially susceptible to infection with the third wave looming over us. [3] India began vaccinating its citizens above 60 years of age earlier from March 1, 2021, followed by the inclusion of citizens above 45 years of age from April 1, 2021, and 18-45 years from April 28, 2021. [4] One of the most important factors that affected the vaccine uptake in the population was the non-availability of the vaccines and other factors such as literacy status and the influence of misinformation. We are reporting an analysis of a follow-up survey performed 3 months since the initial survey in patients aged 45 years and above diagnosed with an ocular surface disease related to auto-immune pathophysiology such as Sjogren's syndrome, Stevens-Johnson syndrome (SJS), ocular cicatricial pemphigoid (OCP), and cicatrizing conjunctivitis to assess the current vaccination status in those who did not receive the vaccine initially. [5] A total of 183 patients were identified using these inclusion criteria and we were able to elicit a response in 133 of them leading to a response rate of 72.67%. The survey contained five questions and was completed through a phone call after obtaining informed consent from the patients. The answers were documented through a Google Form sheet and the responses were analyzed on Microsoft Excel®. Descriptive statistics using mean ± standard deviation and median with inter-quartile range (IQR) were used to elucidate the demographic data.

Overall, 133 respondents responded to the survey. There were 94 (70.68%) female patients and 39 (29.32%) male patients. The average age of the patients was 57.73 ± 9.34 years. The median age was 57 years (IQR 50.5-62) with a mode of 46 years. There were 66 (49.62%) patients with a diagnosis of Sjogren's syndrome, 38 (28.57%) patients with SJS, 14 (10.53%) patients OCP and 15 (11.28%) patients with cicatrizing conjunctivitis. Surprisingly, more than half of the respondents with 77 (57.89%) patients had still not received the vaccine. In the 56 (42.11%) patients who received the vaccine, the majority received Covishield in 44 (33.08%) patients, a minority received Covaxin in 11 (8.27%) patients and Sputnik in 1 (0.75%) patient. Less than a third of the patients received both doses in 15 (26.79%) patients and the majority received only a single dose in 41 (73.21%) patients. A minority of the patients who received the vaccine complained of side effects in 7 (5.26%) patients. Lower vaccination uptake rates were seen among patients with OCP (78.57%) and cicatrizing conjunctivitis (60%). Over half of the patients (56.25%) above 60 years of age and a similar number (47.85%) between 45 and 59 years of age had not received the vaccine since the initial survey. Among the 77 (57.89%) patients who did not receive the vaccine, the most common reasons cited were concerned about their systemic disease (diabetes mellitus, hypertension, cardiac disease, and others) status (45.45%), non-availability of the vaccine stock (16.88%), fear of the taking the vaccine (12.9%), and fear of drug allergy (2.6%). The respondents in 8 (10.39%) calls informed us about the demise of the patients.

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