Comparison of sensitivity and specificity of blue yellow primetry versus standard automated primetry in early / glaucoma suspect patients

Purpose: To compare the sensitivity and specificity of short wavelength automated Perimetry [SWAP] with standard automated perimetry [SAP] using the SITA program to detect early or glaucoma suspect patients

Study Design: Cross sectional prospective and comperitative study of perimetric diagnostic sensitivity and specificity of two perimetric methods in early or glaucoma suspect patients

Study Duration: June 2010 - May 2012

Materials and Methods: Fifty patients with ocular hypertension, early glaucoma or suspect patients were enrolled for the perimetric tests. After complete ophthalmic examination, each patient was tested with the standard automated perimetry [SAP], 30-2 thrice and then on short wavelength automated perimetry [SWAP; 24-2] once

Results: The average MD in the SWAP group was significantly higher than in the SAP Group [SWAP - 6.55ds SAP- 2.60db P<0.001]. A significant difference also existed in PSD between the two groups [SWAP: 3.50db, SAP 2.50db, P<0.001]. The test time was longer in the SWAP group than in the SAP group [SWAP: 15min, SAP 13min P<0.001]. However the sensitivity indices were in normal limits. There were significant differences in number of depressed test point locations between two tests strategies. The number of eyes showing cluster of significantly depressed points were more with the SWAP test strategy than with SAP

Conclusion: The SITA, SWAP identified at least much earlier glaucomatous visual field defects than SITA, SAP. The study showed that greater MD and PSD with SWAP

Familial duane's syndrome

To describe a family suffering from Duane's Syndrome. Case series studies. Diagnosis and Research department of Ophthalmology, Allied Hospital, PMC, Faisalabad Oct 2009 [One month]. A Gentle man, 65 years old, shopkeeper, resident of Jaranwala, Faisalabad, presented with his four children two male and two female with complaint of asymmetry of their unilateral eyes, since birth. There was no history of maternal intake of drugs, or smoking during pregnancy. There was no history of trauma or surgery. On examination the unaided vision of all the study cases was 6/6, 6/6. The cornea, conjunctiva, lens, iris, pupil, vitreous and retina of all the subjects was normal. The IOP of the all was also with in normal range. The ocular motility and lid fissure narrowing was noted in different ocular gazes. The lymph nodes and thyroid gland examination was done. The Hiss screen test was done to quantify individual muscle action. The levator function test, cover tests, papillary reactions, slit lamp examination, fundus examination were performed. The lids fatigue ability tests and strength of hands grip was estimated at the last. All cranial nerves were examined. Urine, blood and thyroid tests were requested and documented. The all the cases had lid fissure narrowing in one of their horizontal gazes. The all of them had under action of one of their horizontal muscles. So all the children had been proved to be suffering from unilateral Familial Duane's Syndrome. In our clinical practice the Familial DS is rarely found. None of the study patients showed amblyopia, diplopia, upshots or down shoots phenomenon. Similarly no associated systemic anomalies were seen

Screening in a school for visual acuity and amblyopia

To detect the visual acuity by Snellen visual acuity chart and then to find out the incidence of amblyopia. A descriptive and observational study. School health section of Divisional public school and eye department of Allied Hospital, PMC, Faisalabad. 15 December, 2008 to 31 March, 2009. A total of 2600 school children between age 8 to 16 years were included in the study. The visual acuity at 6 meters was checked. The pin hole vision and vision with glasses was done of each student for each eye [right and left]. The cover, uncover, alternate cover-uncover tests, Hirschberg test [to observe the deviation] and ocular movements were done for each child. Distance direct ophthalmoscopy, and Bruckner's test[to confirm the deviation] were performed at the same setting. Children having defective vision were checked further at Eye department of Allied Hospital, PMC, Faisalabad. Here slit lamp examination was done to role out corneal, lens or vitreous opacities. The anterior chamber activity was noted Cycloplegic refraction and fundus examination of the selected subjects was done. All the findings were entered in the Proforma. Out of 2600 children, 383 [14.73%] had glasses and normal 6/6, 6/6 vision. Seven children [0.27%] had defective vision. 13 children [0.50%] without glasses had vision less than normal. A total of 20 children [0.77%] were found to be having amblyopia. The total children with glasses were 390[15%] while 2210 children [85%] were without glasses and having normal 6/6, 6/6 vision. Anisometropic amblyopia was found in 8 children [0.31%], isoametropia in 6 children [0.23%], strabismic amblyopia in 3 children [0.12%] and stimulus deprivation amblyopia in 3 children [0.12%]. The study showed that amblyopia is found about 1% in the educated families. This can be further eliminated or decreased with routine or periodical check up of the children not only in school but also at the pre school age

Cataract surgery; Axial length variation

eajaved@hotmail.com. To describe the variation of axial length in patients undergoing cataract surgery. A retrospective case series. At Opthalmological Department, Allied Hospital, PMC, Faisalabad from May 2006 to June 2007. The axial length of 566 patients who were admitted for cataract surgery were measured with A. scan [Axis II, Quantel]. The eleven patients with age below 15 years and above 90 years and with history of trauma, corneal scarring were excluded. So there were 555 patients for this study. A careful history of diabetes mellitus, hypertension, trauma, previous history of surgery, glaucoma and uveitis was taken, and slit lamp examination, tonometry, pupillary reactions, perception and projection of light was done. The data collected was entered in specially designed Performa. An average of ten readings of axial lengths with A-Scan for each patient was taken. Out of 555 patients, there were 350 male [63.06%] and 205 female [36.94%] patients. There were 250[45.05%] patients having age between 46 to 60 years. There were 27[4.86%] patients having age between 15 to 30 years and the same number 27[4.86%] of patients was seem having age between 76 to 90 years. The most of the patients 273[49.18%] had axial length between 23 mm to 25 mm. There were only 3 patients with axial length between 29.01 to 31 mm. There were a significant number of patients, 230[41.45%] having axial length between 21.01 to 23mm. The biometry depends upon axial length, kratometry and anterior chamber depth. Most of the formulae supposed for IOL calculations depend upon only two factors, the axial length and the keratometry. In our community, short and long eyes are very rare and so SRK-T formula for IOL calculations provides satisfactory postoperative results. The axial length carries more importance as its variation causes a gross change in IOL power and postoperative refractive errors

Normal conjunctival flora

To determine the prevalence of normal conjunctival flora and its types. An observational study. At Ophtha-lmological Department, DHQ/Allied Hospital, PMC, Faisalabad, from November 2006 to February 2007. This study was performed on 500 patients, aged form 20 years to 70 years with normal looking eyes. The samples of sterile stuart's swab were made on conjunctiva of patients, without touching eyelashes or lid margins. The swabs were touched with conjunctiva of both eyes and placed in stuart's transparent media to shift to microbiological laboratory. Out of 500 swabs 412 [82.4%] showed no growth while 78 [15.6%] showed microbial growth. Out of these 78 swabs, there were 44 [56.41%] having normal flora, while 34 [43.59%] had other pathogens. The normal looking eyes harbour different types of the organisms. Any trauma, accidental hurt or elective surgical procedure is not free from risk of conjunctival infection, keratits or endophthalmitis etc

Nd: yag laser capsulotomy and complications

To evaluate the complications of Nd: Yag laser when applied on postoperative posterior capsule opacification [PCO], following extra capsular cataract extraction [ECCE] with intraocular lens [IOL]. Analytical and descriptive study. Eye OPD of DHQ Hospital, PMC and Clinic of Professor Zia ud Din Ahmad, Faisalabad. From Jan 2006 to Jan 2007. There were 120 patients; age ranged from 15 years to 80 years with post operated extra capsular cataract extraction with posterior capsular opacification. A Proforma was made which included detailed history of diabetes, hypertension, time period of cataract extraction, other relevant surgical or medical history, and examination e.g. Visual acuity, slit lamp examination, intraocular pressure measurement [applanation tonometry] dilated posterior capsule examination and slit lamp biomicroscopy etc. The patients were kept under observation for 5 hour and called for follow up after one week. Out of 120 patient s 70 eyes showed visual improvement from 6/18 to 6/6 [58.34%], while 30 Shown visual acuity improvement from count figures to 6/24 [25%], mild anterior uveitis occurred in 8 cases [6.67%], corneal damage in 2 cases [1.6%] while transient raised Intraocular Pressure [IOP] in 7 cases [5.83%]. The damage to IOL observed in 3 [2.5%], the corneal damage was seen in 2 cases [1.67%]. The Nd; Yag Laser is very effective, cheap and easy mode of treatment for PCO with minimal post laser complications