Cosmetic outcome of Y-V medial canthoplasty in blepharophimosis syndrome

To determine the cosmetic outcome of Y-V medial canthoplasty with medial canthal tendon shortening in Blepharophimosis syndrome. Quasi experimental study. Department of Ophthalmology, Khyber Teaching Hospital, Peshawar, Pakistan, from June 2005 to April 2008. Thirteen patients of Blepharophimosis syndrome aged 4 years and above were included in the study. Oculoplastic assessment including measurement of horizontal length of palpebral fissure, ptosis and intercanthal distance were done. All patients underwent Y-V medial canthoplasty with medial canthal tendon shortening by a single surgeon. Same measurements were repeated one week postoperatively and then 6 weeks after surgery and results compared with pre-operative findings. Twenty six eyes of 13 patients were included in the study. Ten [77%] patients were female and 3 [23%] were male. Mean age of all patients was 13.54 ñ 6.99 years with a range from 4 to 28 years. Mean horizontal length of palpebral fissure of all 26 eyes was 22.88 mm before surgery and increased to 26.77 mm after surgery. Vertical pre-operative and postoperative height of palpebral fissure was 5.69 mm and 5.34 mm respectively. Mean pre-operative intercanthal distance of 37.46 mm was reduced to 32.08 mm postoperatively. Epicanthus inversus which was present in all [100%] eyes before surgery was successfully treated in 22 [84.6%] eyes after surgery. Y-V medial canthoplasty with medial canthal shortening in Blepharophimosis syndrome has excellent cosmetic outcome

Role of postoperative medical treatment in the management of allergic fungal sinusitis

To evaluate the effectiveness, of postoperative medical treatment in the management of allergic fungal sinusitis with orbital and/or skull base erosion. Descriptive study. This study was conducted in the Department of ENT and Head and Neck Surgery, Khyber Medical College and Khyber Teaching Hospital Peshawar between January 2002 and April 2007. Eighteen cases of allergic fungal sinusitis with orbital and/or skull base erosion were selected for the study. Demographic data like, name, age, sex, address, clinical features, labs and imaging studies were recorded, clinical data including the pre and post-operative medical treatment, operative findings and postoperative results, recurrence of disease were recorded. All patients were divided into three groups on the basis of postoperative medical treatment. Study revealed that Allergic Fungal Sinusitis [AFS] is a disease of younger age, mainly occurring in 2[nd] and 3[rd] decade of life, with male to female ratio 1:1.25. The recurrence was 100% in group-l who were on oral antifungal therapy postoperatively. The recurrence of disease was 40% in patients of group-2 who were on topical nasal steroid, antihistamine and saline irrigation postoperatively. The recurrence rate was much lower 11% in group-3 patients who received oral and topical nasal corticosteroids postoperatively. AFS is a disease of young immunocompetent adults. Surgical debridement and drainage combined with topical and oral corticosteroids can lead to resolution of disease in majority of the cases and prevent recurrences. Antifungal medication has no role in the treatment of allergic fungal sinusitis

Refractive errors in children attending out-patient department of ophthalmology, Khyber teaching hospital, Peshawar

The objectives of the study were to estimate the occurrence of refractive errors in children age up to 15 years, attending outpatient department of Ophthalmology Khyber Teaching Hospital Peshawar, identify their types and provide them with glasses. A repetitive hospital based study. Place and duration of study: Eye Department, Khyber Teaching Hospital, Peshawar, where study was conducted from 1st October 2006 to 31st March 2007. All children age upto 15 years with refractive errors coming to Outpatient Eye Department Khyber Teaching Hospital from 1st October 2006 to 31st March 2007 were included in this repetitive study. Detailed ocular examination was performed on each patient. It consisted of visual acuity testing, pupillary reaction, ocular motility examination, anterior segment examination and direct ophthalmoscopy. The refractive error was noted with type and the patients who needed glasses were provided free glasses. Out of 2340 children 300 [12.8%] had refractive error. Mean age of children was 6 years. Forty five [15%] children were below 3 years, 180 [60%] were between 3-10 years and 75 [25%] were between 11-15 years. One hundred thirty five [45%] were male and 165 [55%] were female. Myopia occurred in 85 [28.33%] Hypermetropia occurred in 75 [25%] and astigmatism in 140 [46.67%] children. Myopic astigmatism occurred in 19 [6.3%], hypermetropic astigmatism in 38 [12.7%] and mixed astigmatism in 83 [27.7%] children. Free glasses were provided to all the children. Anisometropia occurred in 19 [6.3%] patients. Bilateral amblyopia occurred in 10 [3.3%] patients. Unilateral amblyopia occurred in 10 [3.3%]. This study showed that the uncorrected refractive error was a major problem among children. Females were almost equally affected as males. Astigmatism was the most common problem. Treatment for refractive errors is perhaps the simplest and most effective form of eye care

Eclipse retinopathy: Follow up of 36 cases after April 1995 solar eclipse in Pakistan

A study was carried out at the Department of Ophthalmology Ayub Medical College, Abbottabad from April 1995 to April 2002 to study the visual acuity changes in patients of solar eclipse retinopathy. Thirty-six patients with solar eclipse retinopathy were seen. Examination included assessment of Visual Acuity [VA], Slit Lamp examination, Fundoscopy, Fundus Photography and Fundus Fluorescein Angiography where the VA was 6/60. The patients were seen at weekly intervals then at monthly interval and later annually. Poor visual acuity was seen in all patients, after images in 28 patients, Erythopsia in 25 patients and Central Scotoma in 23 patients. Eye involvement was unilateral in 27 cases and bilateral in 9 cases. Twenty-nine patients were male and 7 patients were female. The commonest age group was between 10'30 years. Conclusions: Complete recovery was seen in 26 patients, 7 made partial recovery while in three patients the visual acuity remained poor. Maximum recovery occurred between two weeks to six months. After six months, no changes in the visual acuity or macular lesion were noticed

Frequency of ocular complications of leprosy in institutionalized patients in NWFP Pakistan

There is no systemic disease, which so frequently gives rise to disorders of the eye as leprosy does. The study was conducted to determine the prevalence and gravity of ocular complications in institutionalized leprosy patients in NWFP. It is important to provide necessary information to leprosy health workers and general physicians in order to sensitize them to early detection and treatment or referral to appropriate centre. A prospective study of ocular complications of leprosy patients was conducted at the leprosy centre of Lady Reading Hospital Peshawar and the Leprosy Hospital Balakot, district Mansehra. The study included a record of the name, age, sex, type, duration of disease and completion of multi-drug therapy [MDT]. Classification of the patients was done according to Ridley and Jopling 5-group system. Visual acuity was tested by Snellen chart and those patients having a vision of less than 3/60 were labelled as blind. Ocular adnexa were examined by naked eye and lacrimal sac regurgitation test was done. Slit lamp biomicroscopy was done for anterior segment examination and direct ophthalmoscope was used for fundoscopy. The authors studied 143 patients in the above mentioned leprosy centres. Out of these, 59 had lepromatous leprosy, 39 borderline tuberculoid leprosy, 9 tuberculoid leprosy, 33 borderline lepromatous leprosy, and 33 borderline leprosy. The majority of patients came from the northern districts of NWFP, including Malakand division and district Mansehra. The male to female ratio was 4:1. The age of the patients ranged from 14 to 80 years and the duration of the disease ranged from 1 year to 48 years. Ocular complications were found in 73% of the patients. These complications included loss of eyebrows in 57 patients, loss of eyelashes in 37, corneal changes [including opacity, ulceration, and/or anaesthesia] in 44, iridocyclitis in 31, lagophthalmos in 36, ectropion in 13, and chronic dacryocystitis in 3. Of the total of 15 [11%] patients who went blind from ocular complications, 16 eyes did so due to corneal opacities, 6 eyes due to cataract, 5 eyes due to chronic anterior uveitis and one eye due to corneal ulcer, panophthalmitis and phthisis bulbi each. Conclusions: A significant number of leprosy patients [73%] have ocular complications. The frequency of ocular complications increases with the increasing age and duration of disease of the patients