Late visual recovery in amblyopic eye following the loss of good eye

To report a case of late visual recovery in the amblyopic eye of a 17 year old patient who lost his good eye due to trauma. A case report. A 17 year old male patient presented to outpatient department with recent history of surgical repair of penetrating injury in right eye. He also had previous history of poor vision in the left eye. The corrected visual acuity at the time of presentation was RE = PL and LE = 6/36. He was given spectacle correction for his left eye and topical treatment for his injured right eye which has since become phthisical. His visual acuity in previously amblyopic eye gradually improved from 6/36 to 6/12 and has since then remained stable. Such cases suggest that a significant degree of plasticity does exist in the visual system of adults and amblyopia can be successfully treated in older children and adolescents

Profile of primary open angle glaucoma at a tertiary care Eye Hospital

To report the frequency, demographic pattern and clinical profile of primary open angle glaucoma [POAG] at Al-Shifa Trust Eye Hospital, Rawalpindi. A hospital based cross sectional observational study. All the patients aged 40 years and above reporting for the first time at glaucoma clinic of Al-Shifa Trust Eye Hospital, Rawalpindi from 1[st] July 2006 to 31[st] December 2007. Initial screening of all the patients was done at general outpatient department of hospital. All confirmed or suspected cases of glaucoma were referred to glaucoma clinic. After taking history, a detailed ocular examination of all patients including Snellen visual acuity, slit lamp biomicroscopy, applanation tonometry, gonioscopy and a stereoscopic assessment of cup disc ratio [CDR] was performed. In selected subjects, Heidelberg retinal tomography and automated visual field assessment was advised. Individual treatment plan for each eye was made keeping in view the stage of disease, compliance and affordability of the patient. Statistical analysis of the data was done with statistical software SPSS version 13.0. Out of the total 1068 patients aged 40 years and above, primary open angle glaucoma was diagnosed in 403 [37.73% of total] patients. Among these 403 patients, 250 [62.0%] were male and 153 [38.0%] were female. Male to female ratio was 1.63:1. Age of the patients ranged from 40-103 years with a mean age of 60.64years [ +/- 12.824 Std. Devj. Bilateral POAG was found in 334 patients [82.87%]. 33 [8%] patients were blind at the time of presentation while 134 [33.25%] patients had a cup disc ratio of 0.8 or more in both eyes. 603 [82.82%] eyes were treated medically, while trabeculectomy was the most common surgical procedure performed in 102 [14.01%] eyes. Majority of the patients belonged to Rawalpindi/Islamabad [43%] and Azad Kashmir [9.3%]. POAG is the most frequent type of glaucoma in our population with male predominance. Unfortunately the disease is more advanced at the time of presentation due to lack of public awareness. Despite availability of modern investigations, finding a patient of glaucoma while there is still some useful visual potential to save is still a big challenge for ophthalmologists in Pakistan

Role of preoperative B-scan to detect posterior segment pathologies in eyes with age related mature cataract

To determine the role of B-scan ultrasonography [USG] in pre operative assessment of eyes with age-related mature cataract by documenting the frequency and nature of posterior segment intraocular pathologies detected by it. A hospital based descriptive observational study Two hundred nine [209] eyes with age related mature cataract of the patients presenting at the outpatient department of Al-Shifa Trust Eye Hospital, Rawalpindi from May to August 2003 A detailed ocular and medical history was taken keeping in view the inclusion and exclusion criteria. Eyes of these patients were divided into four groups on the basis of their age. All patients underwent a comprehensive ocular evaluation including visual acuity assessment, slit-lamp examination, pupil reactions and applanation tonometry. B-Scan USG of these patients was performed at both high [58-61 db] and low [42-44db] instrument sensitivity settings. By compiling data obtained by these various scanning approaches, a three dimensional concept of the lesion was developed and its topography adequately documented. SPSS software [Ver.10.0] was used for statistical analysis of results. It was observed that out of 209 eyes considered for simple mature cataract, USG revealed that 29 [13.87%] of them also had some other ultrasonically detectable posterior segment pathologies. 10 [4.78%] eyes out of 209 had vitreous haemorrhage [VH], 9 eyes [4.30%] had PVD, 3 eyes [1.43%] had asteroid hyalosis, 4 eyes [1.91%] had membranes in anterior and mid-vitreous, 2 eyes [0.96%] had chorioretinal layer thickening while one eye [0.48%] had optic disc edema. Pre operative B-Scan ultrasonography of cataract patients, when posterior segment examination is not possible by conventional methods, helps in diagnosis of additional posterior segment pathologies. Knowledge of these hidden posterior segment pathologies will then help the surgeon in explaining prognosis and expected outcome of surgery to patients. Surgeons can modify their plan of surgery and can also take measures to combat various predictable complications. In addition many legal and technical problems can also be avoided