ABSTRACT
Purpose: To study the role of subspecialty hospitals in national disasters, its scope and limitations in context of an eye hospital response during Pakistan October 2005 earth quake
Study Design: A retrospective observational study
Subject and Method: The study was carried out at Al Shifa Trust Eye Hospital Rawalpindi [ASTEH] and comprises of the scope and limitations faced by ASTEH, a subspecialty eye hospital, when it offered its services to the victims of October 2005 earthquake. A special trauma management team from UK with over two dozen specialists joined the hospital voluntarily. A total of 156 patients admitted to the hospital were managed surgically and medically, the limitations and scope analyzed and the patients interviewed at the time of presentation regarding the age, district, mechanism of injury, time elapsed under debris, delay in reporting to the health care facility, type of injury and type of surgery undergone
Results: The limitations faced by the hospital included overwhelmed resources [ASTEH being a charity hospital], budget reallocation, emergency planning, collecting additional donations, funds and grants, providing medical and surgical care to a different class of patients, and provision of accommodation, food, water and electricity to the patients and their attendants. With the help of donations from Pakistan Red Crescent Society and Islamic Help Charity of UK as well as personal donations Al Shifa Trust Eye Hospital effectively managed all the patients. Psychological and emotional support was also provided. 59% of the affected were females. The most common injury was bony fractures in 64% of cases and the most common mechanism of injury was roof collapse. Among ocular injuries again fractures caused by roof collapse were more prevalent
Conclusion: Disaster management is everyone's responsibility. Being a specialized hospital should not bar any health facility to contribute to the national disaster management in hours of need. Al-Shifa Trust Eye Hospital effectively proved that with proper management and networking, a subspecialty hospital can play vital part in national emergencies. The pattern of ocular injuries observed was a unique opportunity for ophthalmic research workers and health policy makers
ABSTRACT
To assess the prevalence of secondary complications and their effect on visual outcome in penetrating ocular injuries. A retrospective review. This study was carried out at Al Shifa Trust Eye Hospital Rawalpindi and consisted of a retrospective analysis of the data of patients presenting with penetrating ocular injuries from 1[st] January 2009 to 30[th] June 2011. At the time of presentation and after final treatment all patients underwent a complete ocular examination. In all cases primary globe repair was performed in the first stage. The percentage of secondary complications and related visual deficiency was calculated taking into consideration degree of penetration and the visual acuity at time of presentation. A proforma was prepared for documentation. A total of 93 eyes, with a male to female ratio of 3:1 and mean age of 20.5 years were enrolled. Overall incidence of post op complications was 55.91% [Cataract 42.3%, Phthisis 34.61%, retinal detachment 26.92%, vitreous haemorrhage 21.15%, endophthalmitis 11.5%, secondary glaucoma and APD 3.84%]. Best corrected final VA of up to or better than 6/12 was found in only 19.35% of patients. At the end of three months, the cases with normal vision were 16.3%, visual impairment 19.6%, severe visual impairment 04.1% and monocular blindness 60.8%. Penetrating ocular trauma in Pakistan has a high rate of secondary complications which carries a poor visual prognosis and leads to monocular blindness in signified number of cases