Axial length variability in cataract surgery

To determine the mean axial length and biometric measures in patients undergoing cataract surgery and further compare the variability of axial length between the gender and with age. Cross-sectional observational study. Eye Unit I, Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Hyderabad, Pakistan from January 2010 to December 2012. All patients referred for cataract surgery were assessed. The study included 886 eyes which were straightforward cataract cases with no other ocular problem. The data was collected for axial length, keratometric values and Intra-Ocular Lens [IOL] power prior to cataract surgery. The collected data was then analyzed using SPSS version 19 for windows software. Gender based comparison showed significant difference in age, axial length, keratometric values and IOL power between the two groups [p=0.000]. 86% of the eyes had an axial length between 21.00 mm and 23.99 mm. In univariate analysis there was significant [p=0.000] relation between overall age and axial length. The keratometric values ranged between 36.75 D and 52.50 D. Majority of the IOL powers ranged between 20.00 D and 23.00 D. The mean axial length of patients undergoing cataract surgery was 22.96 +/- 1.04 mm, was comparable to Indian and Chinese population but shorter than the Western population. Females had shorter axial lengths, similar to other studies. Axial length was positively associated with age among the females, the cause of which is yet to be determined

Congenital myasthenia gravis

Congenital myasthenia gravis is caused by genetic mutations affecting neuromuscular transmission, characterized by muscle weakness usually starting in childhood. A two and a half years old male child presented with bilateral ptosis and hoarseness of voice. The symptoms progressed giving the clinical impression of congenital myasthenia gravis. A series of tests were done including Ice Pack Test, acetylcholine receptor antibody test, trial of steroids and finally neostigmine test which confirmed the diagnosis. This case illustrates the challenges in diagnosing congenital myasthenia gravis and highlights the potential benefits of neostigmine test in its diagnosis