Effect of diabetes on ocular lens thickness

To determine the effect of hyperglycemia on thickness of crystalline lens of eye in diabetic population and its comparison with non-diabetics of same age group. Cross sectional observational study. The study was conducted at Railway General Hospital, Rawalpindi. A total 112 patients over a period of six months were included in study. Ocular lens thickness was measured in 56 diabetic patients and 56 non-diabetic controls by using A-scan biometry. Parameters like duration of diabetes and type of medication were recorded. 112 patients were divided into two groups. In diabetic group [56 patients], most of the patients i.e. [42%] had BSR more than 200 mg/dl. Out of 56 controls, most of the subjects i.e. 54%] had BSR between 70-90mg/dl. Thickness of crystalline lens was in the range of 4.00-6.21 mm with mean of 5.10mm in diabetics and in range of 4.00-4.50mm with mean of 4.16mm in non-diabetic controls. Thickness of crystalline lens was increased in patients who had diabetes for at least 10 years as compared to normal controls

Visual outcome in strabismic and anisometropic amblyopia after patching therapy

To assess the visual outcome after occlusion therapy in amblyopia and to compare the results of occlusion therapy in strabismic and anisometropic amblyopia. A hospital based prospective interventional study. Pediatric Ophthalmology unit of Al-Shifa Trust Eye Hospital Rawalpindi from June 2000 to February 2001. Complete history of all patients was taken. Visual acuity was checked both for near and distance, with and without glasses, and with pinhole followed by cycloplegic refraction. Slit lamp / fundus examination was performed to rule out any organic pathology. Most accurate optical correction and then part-time occlusion therapy was instituted while alternate patching was advised in bilateral amblyopes. All the patients were followed for a minimum period of 6 months. The study population comprised of 50 amblyopic children. The age of these patients ranged from 3 to 8 years with a male to female ratio of 3:2. Unilateral amblyopia was detected in 40 [80%] patients while 10 [20%] had bilateral amblyopia. 15 [30%] patients had purely strabismic amblyopia, 22 [44%] patients had mixed amblyopia while 13 [26%] patients had purely refractive amblyopia. 10 [20%] patients had mild amblyopia, 30 [60%] patients had moderate amblyopia, 10 [20%] patients had severe amblyopia. After treatment 39 [78%] patients achieved the level of successful visual acuity [6/12 or better]. Younger the patient when treatment was first instituted, the better was the result. If the visual acuity was better in the amblyopic eye before treatment, the better was the prognosis. High anisometropia tends to worsen the prognosis

Excimer laser; photorefractive keratectomy for 1.50 to 3.50 diopters of myopia [six months follow up]

To evaluate the efficacy and safety of excimer laser photorefractive keratectomy for myopia in Pakistani people. Prospective study. At Al-Shifa Trust Eye Hospital Rawalpindi. October, 1995 and Febrauray, 1996. The study group of thirteen patients, comprises of 25 eyes, with refractive error ranging from -1.50 to -3.50 D.S [diopters sphere] and less than -1.50 D.C [diopters cylinder]. Thirteen eyes [52%] lost to follow up after three months. Only twelve eyes [48%] could be reviewed at six months after photorefractive keratectomy. At one month, eleven eyes [44%] and at three months, eight eyes [32%] were hypermetropic within +0.25 to+1.00 diopters of spherical equivalent .At six months only three eyes [25%] had hypermetropia within +0.25 to +1.00 diopters spherical equivalent. None of the eyes had any kind of astigmatism more than 1.00 diopter. No over correction of more than +1.00 diopter of spherical equivalent was observed in any case. At one month, three months and six months after photo-refractive keratectomy, 88%, 80% and 100% eyes had 6/6 visual acuity respectively, without any optical aid. Hundred percent of the eyes showed complete healing of the epithelium on third post operative day. Moderate to severe postoperative pain was experienced by every one for three days with gradual reduction in intensity. Only one eye [8.33%] had grade 1 haze at six months. Rests of the eyes were clear .No vision threatening complications occurred. Despite the short term follow up, photorefractive keratectomy appears to be an effective and safe procedure with good predictability for the correction of low myopia. Despite relatively short term follow up of the study; photo refractive keratectomy [PRK] appears to be safe and quite predictable procedure for correction of low myopia

Spectrum of congenital and developmental anomalies of eye

The purpose of this study was to determine the type and frequency of congenital/ developmental defects and to gather baseline data for future studies on congenital/ developmental anomalies of eye. Retrospective and prospective case series. The study was conducted at Al-ShifaTrust Eye Hospital Rawalpindi over a period of 3 years in the Paediatric Ophthalmology Department which included recording of visual acuity, complete anterior and posterior segment examination and cycloplegic refraction of 514 patients that formed the study group. 45.3% of the children had no visual impairment, while 54.7% had severe visual impairment/blindness. The most frequent anomaly seen was cataract [23%], followed by nasolacrimal duct obstruction [20%]. Congenital ptosis, followed by blepharophimosis was important lid anomalies. Among the retinal disorders [15% of the total], pigmentary retinal degenerations contributed to 44% while albinism and maculopathies were the other important anomalies. Congenital anomalies of the optic nerve, cornea and defects involving the whole globe were found less frequently. Consanguinity was positive in 56% of the cases. A positive family history was obtained in 10% of the cases. 77.5% of the children were amenable to treatment at the time of presentation, while 22.5% could not be offered any treatment. Overall, more than half of the children [51.2%] underwent some sort of surgery. Spectacles, low vision aids and conservative management were offered as other mode of therapy. In Pakistan there is significant prevalence of congenital anomalies. Consanguinity is one of the major contributory factors for hereditary and congenital eye diseases. Public health education about the problems of consanguinity and community awareness about availability of genetic counseling services needs to be promoted