Visual rehabilitation of patients with Stargardt's disease

To assess the role of low vision devices in visual rehabilitation of patients with Stargardt`s disease. Descriptive study. The Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex, Peshawar, Pakistan, from June 2003 to June 2005. Patients diagnosed as having Stargardt`s disease and confirmed by two senior ophthalmologists clinically and after fluorescein fundus angiography and Electro-Retinogram [ERG] when needed, were included in the study. Patients with fundus pathologies other than Stargardt`s disease were excluded. Each subject underwent an ophthalmic examination. Visual acuity was tested with a logarithm of the minimum angle of resolution chart; Feinbloom chart and Snellen type. Low vision assessment was performed on all individuals. SPSS version 10 was used for analysis of the data regarding the severity of visual impairment, visual acuity and devices used for aiding vision. Chi-square test was used for comparison of proportions. Of this cohort of 64 patients, 72% were aged between 7 to 15 years and 28% were 16 to 32 years. Using WHO low vision criteria, the percentage of visually impaired, severe visually impaired and blind [at the time of presentation] were 56.3%; 31.3% and 9.4% respectively. Among those patients, 3.1% had distance visual acuity of 6/18 or better in the better eye and 53% had normal near visual acuity of 1M [0.8 print size]. Telescopes were prescribed to 53% patients for enhancement of distance visual acuity to meet their needs. Stargardt's patients respond well to magnification. Simple bifocal glasses may be used in the early stages. Visual rehabilitation can help Stargardt's patients to learn independence in their activities of daily living

Protosis: etiology and demographic patterns

To determine the demographic pattern of patients presenting with proptosis and its etiology. A cross-sectional descriptive study. Khyber Institute of Ophthalmic Medical Sciences [KIOMS], Hayatabad Medical Complex, Peshawar from July 2001- December 2002. Sixty cases of proptosis presenting at KIOMS were included. Thirtysix patients were male while 24 were female. They were divided into two age groups; 0-15 years [paediatric group] and above 15 years [adult group]. An elaborate work up plan was formulated for all patients, which included detailed history, clinical examination [ocular, orbital and systemic], radiological and histopathological investigations. Neoplasms [33%] were the most common causes of proptosis in all the patients followed by orbital inflammations [23%], orbital infections [20%], structural abnormalities [12%], vascular abnormalities [7%] and trauma [5%]. Neoplasms were the most common cause of proptosis in both paediatric and adult group. Proptosis was the cardinal feature and visual deterioration was present in more than half of the patients. Timely referral, early diagnosis and appropriate management can result in reduction of visual morbidity

Frequency and visual outcome of traumatic cataract

To assess the frequency, causative agents, current treatment options, post-operative complications and final visual outcome of trauma related cataract. The study was conducted at Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex, Peshawar, from November 1999 to November 2001. Detailed history with special reference to age, sex, mode of injury, causes and circumstances of trauma were recorded. Indications for surgery were traumatic cataract with or without open globe injury. All patients had B scans [ultrasonography] to evaluate the posterior segment. All patients were operated under general anaesthesia. The patients were followed up for six months. Out of 77 patients with traumatic cataract [69 males and 8 females], about half of the patients were between 5-15 years of age Commonest trauma was sport related in 32 [41.5%] cases. Commonest etiological agent for blunt trauma was stone in 15 [19.48%] cases and for penetrating trauma was thorn in 9 [11.7%] cases. In 71 patients [92.20%] presenting visual acuity was less than 6/60. Fifty three patients [68.83%] had final visual acuity of 6/6-6/12 while only 03 patients [03.89%] had a final visual acuity of<3/60. Traumatic cataract is common cause of visual loss after trauma. Males are affected more than females. Nearly half of patients affected are children under the age of 16. Taking necessary precautions for sports and work can prevent nearly 54% of cataracts. Most common causative agents are stone and wooden sticks

Clinical profile of amblyopia in Pakistani children agy 3 to 14 years

To study the clinical profile of amblyopia in children age 3 to 14 years. A cohort study. The study was conducted over a period of two years from June 2001 to June 2003 at Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex, Peshawar, Pakistan. This study included 316 children. Visual acuity was tested with Snellen type and Lea symbols chart according to the level of cooperation of the children. Cycloplegic refraction and orthoptic assessment was performed on all children. One hundred and eighty-two children were between 3 to 8 years age and 134 were between 8 to 14 years. Mean age was 8 years. One hundred and twenty children had strabismic amblyopia, 136 children had anisometropic amblyopia, while 60 children had combined mechanism amblyopia [strabismus and anisometropia both]. The results indicate the importance of screening school-going children for refractive error and amblyopia and the importance of a future prospective study on the magnitude, cause and treatment of amblyopia at more treatable age