ABSTRACT
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
ABSTRACT
Since July 1991, the Federal Ministry for Health and Provincial Health Departments with the support of international agencies is in the process of replacing the routine reporting system of the government managed First Level Care Facilities [FLCFs] with a more comprehensive Health Management Information System [HMIS]. A descriptive study was conducted to appraise the level of information generated by two FLCFs through the HMIS reports The reports were evaluated for malaria tuberculosis priority listing diseases and maternal health related issues, addressed routinely at the rural health centers. In the year 2000, it was observed that new cases of fever at RHC Khalian were reported to be 1069 and 243 slides [23%] were prepared to diagnose malarial parasites. In comparison, Kotli Loharan reported 275 cases of fever and prepared 253 slides. Total 46 cases of cough were reported by RHC Khalian and no smear was done for acid fast bacilli. In RHC Kotli Loharan, 14 cases of cough were reported and only 6 smears were done. RHC Khalian registered 21% of the expected pregnancies, assisted only 5% of the expected deliveries and provided postnatal care [PNC] to 30% of women. In comparison, RHC Kotli Loharan, registered 66% of pregnancies, out of these, 27% were attended at the time of delivery and 79% were given PNC. At RHC Khalian, 16% of the total cases reported were diarrhoeal cases while in RHC Kotli Loharan, these cases were only 7% of total reported cases of ill health. It is concluded that the HMIS reports generated at the two RHCs have proved to be an important tool in assessing the quality and quantity of services provided at FLCFs. This is only true if the HMIS reports are filled properly and timely feedback is provided to these facilities