Frequency of Ocular Diseases in Infants at a Tertiary Care Hospital

PURPOSE: To determine the frequency of ocular diseases in infants visiting the ophthalmology department of a tertiary care hospital. METHODS: This was a cross-sectional descriptive study conducted in the department of ophthalmology, Abbasi Shaheed Hospital, from January 2015 to May 2016. The study included 377 infants ranging in age from 1 day to less than 1 year who were, selected by a nonprobability consecutive sampling technique. A detailed history was taken, and a complete ocular examination was performed. Descriptive statistics were used to calculate the mean and standard deviation for age. Frequencies were calculated for ocular diseases along with the percentages. Outcome variables included various congenital and acquired diseases such as conjunctivitis, congenital cataract, glaucoma, nasolacrimal duct blockage, squint, trauma, and fundus abnormalities. RESULTS: The mean age of infants was 5.0 ± 3.7 months. There were 196 (52%) males and 181 (48%) females. The sample included 330 (87.5%) full term infants. Acquired ocular diseases occurred in 230 (61%) infants; and congenital diseases, in 147 (39%). The most common ocular disease was conjunctivitis, which occurred in 173 (46%) infants, followed by congenital blocked nasolacrimal duct, which occurred in 57 (15 %) infants. Conjunctivitis was more common among neonates than infants. CONCLUSIONS: Acquired ocular diseases were more common than congenital ocular diseases. The most common ocular pathology was conjunctivitis, followed by congenital nasolacrimal duct obstruction, in infants. Conjunctivitis was more common in neonates than infants.

Terrien's marginal degeneration: easily manageable

Terrien's marginal degeneration is a slowly progressive, non-inflammatory condition, usually bilateral, more commonly affecting males. We are reporting a case of bilateral Terrien's marginal degeneration with spontaneous perforation in right eye. He was managed with primary repair of perforation with polyglactin [coated vicryl] 8/0. It was followed by cataract surgery of dense cataract to improve vision. Patient was 6/12 aided postoperatively

Management of a congenital cyst of the orbit in a five year old

We report here the case of a 5 year old female child who presented at Eye department of Abbasi Shaheed Hospital with gradually increasing proptosis of left eye ball since birth. There was no light perception in the eyeball. Examination revealed a cystic swelling in inferolateral part of the orbit causing superomedial displacement of the orbit with restriction of extraocular movements. In addition there was microcornea, miccrophthamos and coloboma of iris extending posteriorly to the optic nerve. Right eye showed microphthalmos, microcornea, nystagmus on attention and a reacting pupil with visual acuity of finger counting at two feet. CT scan showed a large smooth walled hypodense lesion arising from inferolateral aspect of the orbit displacing the eye ball superomedially along with remodeling of adjacent bones.The cyst was successfully removed through subcilliary incision under general anaesthesia. Continuation of the cyst with optic nerve was seen peropeatively. Histopathology revealed a benign cyst with lining of single layer of epithelium and wall composed of aggregates of lymphocytes congested blood vessels and skeletal muscles. Findings were consistent with colobomatous cyst of the orbit

Risk factors associated with pre-senile cataract

To determine frequency of various risk factors associated with presenile cataract among patients schedule for cataract surgery. Study was conducted at Abbasi Shaheed Hospital and Karachi Medical Dental College between October 2007 and September 2009. Patients of cataract of age 30-55 years were selected. Presence of risk factors like diabetes mellitus, high myopia, occupational exposure to metal work, atopic dermatitis and smoking were noted. Visual acuity, anterior and posterior segments were examined and axial length was measured. Two hundred fifty four patients satisfying inclusion criteria were selected. These included 181 male [mean age 44.7 years] and 73 females [mean age 43.8 years]. Unilateral eye involvement was present in 108 patients while bilateral involvement was present in 146 patients. Risk factors frequency was diabetes [26%], high myopia [16.1%], smoking [15%], metallic exposure [3.1%], atopic dermatitis [2%] while 37.8% were idiopathic. Significant difference were found in frequency of risk factors [p=0.004] and mean age according to presence of risk factors [p=0.001]. While no significant association was found of age with risk factors [p=0.7] and gender [p=0.24]. Our study shows that idiopathy contributed to most of the cases of presenile cataract followed by diabetes mellitus, high myopia and smoking

Visual outcome in panretinal photocoagulation in proliferative diabetic retinopathy at one year follow up [a study of 100 cases at Abbasi Shaheed hospital]

Purpose of our study was to evaluate the visual outcome with panretinal photocoagulation in proliferative diabetic retinopathy at one year follow up. It was retrospective, analytical, observational type of study. The study was carried out at eye department Abbasi Shaheed Hospital from March 2007-April2008. The results of our study are as follows: 150 eyes of 100 patients with type 2 diabetes mellitus were studied over a period of one year that is from March 2007-April 2008. 68% patients in our study were between 40-50 years of age and 32% between 50-60 years of age. 72% patients were males and 28% patients were females. 150 eyes of 100 patients were treated and they were followed up for 1 week, 3 months, 6 months and 1 year after PRP. Our study included 150 eyes of 100 patients 11 patients[16] eyes were in follow up. In our study 65% patients maintamed their visual acquity between 6/36-6/18.13% had improved visual acquity upto 6/12- 6/9 and 22% had their visual acquity deteriorated to 6/60- perception of hand movement. Causes of decreased vision in our study were progression of cataract 16%, lschaemic maculopathy 26%, vitreous heamorrhage 42% and preretinal fibrosis 16%. It was concluded that PRP should be initiated early to be most effective in management of PDR

Role of intraoperative application of mitomycin C to prevent recurrence of pterygium after excision using bare sclera technique [a study of 50 patients at Abbasi Shaheed hospital]

The objective of our study was to prevent the recurrence of pterygium with application of intraoperative Mitomycin C following pterygium excision using bare sclera technique. This was an observational study and carried out at eye department Abbasi Shaheed Hospital Karachi. Fifty patients were studied over a period of 9 months. Patient information regarding visual aquity, intraocular pressure, retinoscopy condition of cornea, conjunctiva and retina were recorded on a predesigned performa. Patients were admitted in the ward and operated in sterilized operation the-atre environment. Mitomycin C was applied on bare sclera in a concentration of 0.02% [0.2 mg/ml] for 2.5 minutes and irrigated with copious amount of normal saline afterwards. Patients were discharged next day on mild steroid like flouromethalone and an antibiotic ointment. Follow-up was done on first week, one month, 3 months and six months. Rate of recurrences and postoperative complications were noted down. There were 72% male and 28% female patients .Most common presenting age group was between 30-40 years of age [42%]. Primary pterygia included in the study were 90% [45 patients] and recurrent were 10% [5 patients]. Recurrence rate in primary pterygia was 6.6% [3 patients] and in recurrent pterygia 20% [1 patient]. No major complication was recorded. It was concluded that intraoperative application of Mitomycin C on bare sclera is safe and effective in preventing the recurrence of pterygium after excision provided potential complications of Mitomycin C are sufficiently addressed